WO2008020329A2 - Administration of cells and cellular extracts for rejuvenation - Google Patents

Administration of cells and cellular extracts for rejuvenation Download PDF

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Publication number
WO2008020329A2
WO2008020329A2 PCT/IB2007/003266 IB2007003266W WO2008020329A2 WO 2008020329 A2 WO2008020329 A2 WO 2008020329A2 IB 2007003266 W IB2007003266 W IB 2007003266W WO 2008020329 A2 WO2008020329 A2 WO 2008020329A2
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Prior art keywords
cells
skin
composition
extracts
cell
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PCT/IB2007/003266
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English (en)
French (fr)
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WO2008020329A3 (en
Inventor
Runhild Gammelsaeter
Jan Remmereit
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Regenics As
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Priority to EP07825530.4A priority Critical patent/EP2101724B1/de
Priority to JP2009508547A priority patent/JP5641734B2/ja
Priority to CA2651856A priority patent/CA2651856C/en
Priority to EP12178381.5A priority patent/EP2656832B1/de
Priority to AU2007285483A priority patent/AU2007285483B2/en
Publication of WO2008020329A2 publication Critical patent/WO2008020329A2/en
Publication of WO2008020329A3 publication Critical patent/WO2008020329A3/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/56Materials from animals other than mammals
    • A61K35/60Fish, e.g. seahorses; Fish eggs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/70Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7088Compounds having three or more nucleosides or nucleotides
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/12Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
    • A61K35/36Skin; Hair; Nails; Sebaceous glands; Cerumen; Epidermis; Epithelial cells; Keratinocytes; Langerhans cells; Ectodermal cells
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • A61K38/02Peptides of undefined number of amino acids; Derivatives thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/30Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
    • A61K8/60Sugars; Derivatives thereof
    • A61K8/606Nucleosides; Nucleotides; Nucleic acids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/30Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
    • A61K8/64Proteins; Peptides; Derivatives or degradation products thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/30Cosmetics or similar toiletry preparations characterised by the composition containing organic compounds
    • A61K8/64Proteins; Peptides; Derivatives or degradation products thereof
    • A61K8/65Collagen; Gelatin; Keratin; Derivatives or degradation products thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/96Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution
    • A61K8/97Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution from algae, fungi, lichens or plants; from derivatives thereof
    • A61K8/9783Angiosperms [Magnoliophyta]
    • A61K8/9789Magnoliopsida [dicotyledons]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/96Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution
    • A61K8/98Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution of animal origin
    • A61K8/981Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution of animal origin of mammals or bird
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/96Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution
    • A61K8/98Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution of animal origin
    • A61K8/981Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution of animal origin of mammals or bird
    • A61K8/982Reproductive organs; Embryos, Eggs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K8/00Cosmetics or similar toiletry preparations
    • A61K8/18Cosmetics or similar toiletry preparations characterised by the composition
    • A61K8/96Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution
    • A61K8/98Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution of animal origin
    • A61K8/987Cosmetics or similar toiletry preparations characterised by the composition containing materials, or derivatives thereof of undetermined constitution of animal origin of species other than mammals or birds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • A61P17/02Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • A61P17/16Emollients or protectives, e.g. against radiation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P19/00Drugs for skeletal disorders
    • AHUMAN NECESSITIES
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    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P21/00Drugs for disorders of the muscular or neuromuscular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P39/00General protective or antinoxious agents
    • A61P39/06Free radical scavengers or antioxidants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P43/00Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61QSPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
    • A61Q19/00Preparations for care of the skin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61QSPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
    • A61Q19/00Preparations for care of the skin
    • A61Q19/004Aftersun preparations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61QSPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
    • A61Q19/00Preparations for care of the skin
    • A61Q19/08Anti-ageing preparations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61QSPECIFIC USE OF COSMETICS OR SIMILAR TOILETRY PREPARATIONS
    • A61Q19/00Preparations for care of the skin
    • A61Q19/06Preparations for care of the skin for countering cellulitis

Definitions

  • the invention relates to improving visible parts of a person contributing to cosmetic appearance directly or indirectly, including but not limited to skin, hair, subcutaneous fat, cartilage, muscle, skeletal structures, and to improving health and damage of cells and tissues preferably skin, and more preferably restoring aged skin to a youthful appearance.
  • the invention relates to a composition comprising i) differentiable cells, ii) extracts from cells or eggs or iii) components thereof, which can induce differentiation and extract components purified or synthetic nucleic acid sequences, polypeptides, or natural products contained in the extracts.
  • the cells are differentiable cells, preferably stem cells.
  • the compositions are used in a method that comprises application of compositions to skin and/or wounds after removal the outer surface layers.
  • the invention relates to a method of de- differentiation of cells and/or de-differentiation followed by re-differentiation.
  • the invention relates to managing, preventing, and treating skin diseases.
  • This invention also relates to the use of compositions comprising differentiable cells, egg cellular extracts or differentiable cell cellular extracts to prevent deterioration, damage and malfunction of cells and tissues, and to promote, improve and exceed cellular function in order to promote, improve and exceed appearance, vitality and health of cells and tissues.
  • Skin is the first barrier we have against outside aggressions, and carries out both physical and chemical defenses.
  • Vitamin D is produced in the epidermis under the effects of solar radiation. This vitamin is necessary for calcium to be absorbed in the intestine and then fixed on the bones, which enables the development and growth of the human body.
  • excessive sun exposure leads to skin damage and potentially cancer.
  • skin cells may become damaged by physical means, i.e., wounded, or damaged due to age.
  • Simple tissues such as fat, connective tissue, and epithelium regenerate, but the skin, being a complex organ derived from 2 germ layers, heals by the formation of a predominantly fibrous tissue. If the injury sections or destroys the papillary layer of the stratum comeum, a scar will be formed. Sometimes, this scar is inconspicuous; other times, it may be disfiguring. The most common presenting concern of patients with abnormal scars is disfigurement. However, some patients experience other symptoms in association with their abnormal scar, such as pain, pruritus, and loss of motion. These other symptoms can be indications for surgical correction of the scar. Thus, there is a need to identify compositions and methods of managing, preventing, and treating scars.
  • the invention relates to improving visible parts of a person contributing to cosmetic appearance directly or indirectly, including but not limited to skin, hair, subcutaneous fat, cartilage, muscle, skeletal structures, and to improve health and damage of cells and tissues preferably skin, and more preferably restoring aged skin to a youthful appearance.
  • the invention relates to compositions of cells, cell or egg extracts, and extract components which can induce de-differentiation, including but not limited to purified or synthetic nucleic acid sequences, polypeptides, or natural products contained in the extracts.
  • the cells are differentiable cells, preferably stem cells.
  • the compositions are used in a method that comprises application of the compositions to skin and/or wounds after removal the outer surface layers.
  • the invention relates to a method of de-differentiation of cells and/or de- differentiation followed by re-differentiation.
  • the invention relates to managing, preventing, and treating skin diseases.
  • the invention relates to repair or de novo formation of lost or damaged tissues, organs and limbs.
  • the invention relates to a composition comprising i) a cellular component comprising differentiable cells, differentiable cell cellular extracts, egg cellular extracts or components of differentiable cell extracts or egg cellular extracts or combinations thereof and ii) lipids.
  • the composition further comprises purified or synthetic nucleic acid sequences, proteins, epigenetic inhibitors, or natural products contained in the extracts or combinations thereof.
  • the differentiable cells are embryonic stem cells, embryonic germ cells, or adult stem cells.
  • the present invention is not limited to the use of any particular cellular extract or fraction. Indeed, the use of a variety of cellular extract and fractions is contemplated, including, but not limited to, cytoplasmic extracts and fractions, nuclear extracts and fractions, water soluble extracts and fractions, and extracts and fractions prepared from cellular extracts by affinity chromatography, gradient centrifugation, HPLC, size exclusion chromatography and the like.
  • the invention provides methods and the compositions find use for prevention of deterioration, damage and malfunction of cells and tissues, and to promote, improve and exceed cellular function in order to promote, improve and exceed appearance, vitality and health of cells and tissues.
  • the invention provides a skin healing composition
  • a skin healing composition comprising i) a cellular component selected from the group consisting of differentiable cells, differentiable cell cellular extracts and an egg cellular extract or combinations thereof and ii) a lipid component.
  • the synthetic protein is a fusion-trojan protein.
  • the composition further comprises natural vernix, vernix extracts, vernix made from synthetic components, and components of vemix extracts.
  • the lipid component comprises squalene, aliphatic waxes, sterol esters, diol esters, triglycerides, and free sterol.
  • the lipid component is derived from egg from fish, shrimp, sea urchin or frog and/or fish roe. In further embodiments, the lipid component contains cholesterol, fatty acids, and ceramides. In some embodiments, the lipid component is from a source different than the cellular component. In further embodiment, the composition contains keratin or flaggrin. In further embodiments, the composition further comprises glutamine, antiinfective agents, antioxidants and/or nicotinamide. In further embodiments, the antioxidant is vitamin E, A, or C or combinations thereof.
  • the invention provides a kit for improving the appearance of a scar comprising two compositions, wherein the first composition dissolves scar tissue and comprises collagen dissolving agents and the second composition improves wound healing and comprises a cellular component selected from the group consisting of differentiable cells, differentiable cell cellular extracts and an egg cellular extract or combinations thereof, lipids, proteins, and water.
  • the differentiable cells are embryonic stem cells, embryonic germ cells, or adult stem cells.
  • the first composition further comprises an antiseptic, an antibacterial, an anti-inflammatory, an immunomodulator, a protease, or an analgesics or combinations thereof.
  • the second composition further comprises natural vernix, vernix extracts, vernix made from synthetic substances, and components of vemix extracts.
  • the lipid component comprises squalene, aliphatic waxes, sterol esters, diol esters, triglycerides, free sterols or combinations thereof.
  • the lipids and/or proteins are derived from eggs from fish, shrimp, sea urchin or frog and/or fish roe.
  • the lipid fraction contains cholesterol, fatty acids, or ceramides or a combination thereof.
  • the lipid component is from a different source than the cellular component.
  • the composition further comprises glutamine, antiinfective agents, antioxidants and/or nicotinamide.
  • the invention provides methods for improving the appearance of a skin comprising: i) removing skin tissue by chemicals, a laser, or physical force and ii) applying a composition that improves wound healing comprising differentiable cells, differentiable cell or egg cellular extracts, components of differentiable cell extracts, lipids, proteins, and/or water.
  • improving the appearance of skin includes improving the appearance of a scar or improving the appearance of skin with wrinkles.
  • the differentiable cells are embryonic stem cells, embryonic germ cells, or adult stem cells.
  • the composition further comprises natural vernix, vernix extracts, vemix made from synthetic substances, and components of vernix extracts.
  • the invention provides methods for the topical administration of differentiable cells, egg or differentiable cell cellular extracts, components of cell extracts comprising: providing a composition comprising a cellular component component comprising differentiable cells, egg or differentiable cell cellular extracts, components of cell extracts and a subject having skin and applying the extracts to the skin of the subject.
  • the egg or differentiable cellular extracts or components of cell extracts are effective as a nutrient to a cell of the skin.
  • the composition is a water-based gel.
  • the water- based gel comprises a compound selected from the group consisting of hyaluronic acid and chitosan.
  • the composition is a component on a wound dressing. In further embodiments the composition is a component in a spray composition. In further embodiments the spray composition is an aerosol. In further embodiments, the spray composition dries on the skin. In further embodiments, the spray composition comprises gel-forming components. In some embodiments, the composition further comprises a lipid component as described above.
  • the invention provides a wound healing dressing comprising a composition comprising differentiable cells, egg or differentiable cell cellular extracts, and components of cell extracts.
  • the invention provides methods for the topical administration of differentiable cells, cell extracts, components of cell extracts comprising: i) providing a) a composition containing differentiable cells, differentiable cell or egg cellular extracts, components of cell extracts, b) a subject having a wound in skin and c) wound dressing ii) applying the differentiable cells, cell extracts, components of cell extracts to the wound; and iii) covering the wound with the wound dressing.
  • the wound dressing is non-occlusive.
  • the wound dressing is plaster.
  • the wound dressing comprises: i) a waterproof layer; ii) a nutrient gel layer comprising differentiable cells, cell extracts, and components of cell extracts.
  • the waterproof layer is a plastic membrane that can be glued onto skin.
  • the nutrient gel layer comprises antibacterial agents and collagen modulating substances.
  • the nutrient gel layer improves the speed of wound healing.
  • the invention provides methods for the topical administration of differentiable cells, egg or differentiable cell cellular extracts, or components of cell extracts comprising: i) providing a) a subject having 1) a wound in skin and 2) a tissue comprising specialized cells b) wound dressing; ii) harvesting the specialized cells from the tissue; iii) culturing the specialized cells under conditions such that a composition comprising the cultured specialized differentiable cells, cell extracts, or components of cell extracts is formed; iii) applying the composition to the wound; and iii) covering the wound with the wound dressing.
  • the specialized cells selected from the group consisting of a bulge hair-follicle stem cell, an embryonic stem, or germ stem cell.
  • the composition is a fluid suspension of specialized cells.
  • the composition is a plaster.
  • the composition is placed on a membrane with a nutrient gel layer prior to applying the composition to the wound.
  • the membrane is plastic functioning as an occlusive wound dressing when applied to the skin.
  • the wound dressing is a commercial band-aid.
  • prior to applying the composition a step of burning skin is performed, freezing skin is performed, and/or sanding skin is performed.
  • a transport vehicle which penetrate intact skin is applied to the composition or skin comprising a phospholipids, palmitylmyristrates, DMSO, polymer or chitosan suspensions or matrix, liposomes and/or trojan peptides, chariot peptides (nature biotech 2000), small elastic vesicles (Van den Bergh et al., 1999), microspheres, nanoparticles, preloaded spherical beads, uni- and/or multilamellar vesicles, retinol molecular film, poly acrylo nitrile, beta-glucan (Redmond, Int Journ Cosmetic Science 2005), propylene glycol, butylenes glycol, polyethylene glycol, olive oil, dimethyl isosorbate, dimethylformamide, methyl salicylate, long chain oleic acids..
  • the invention provides compositions for stimulating cells such as fibroblasts and keratinocytes comprising an effective amount of a purified cytoplasmic fraction of an embryonic stem cell, progenitor cell, somatic cell or eggs from animals, including but not limited to primates, rodents, fish, shrimp, sea urchin and/or frog egg.
  • the composition further comprises fats, proteins and/or natural products.
  • the composition further comprises an herbal substance.
  • the herbal substance is aloe vera.
  • the composition further comprises seed extracts.
  • the seed extracts are obtained from wheat, corn, rice, or avocado.
  • the composition further comprises a plant oil.
  • the composition further comprises a fungal substance.
  • the fungal substance is nepal fungus.
  • the composition further comprises fish, shrimp, sea urchin, or frog egg extracts, or components of these egg extracts.
  • the components of egg extracts are glycosylation breakers and inhibitors.
  • the components of egg extracts are glycosylation breakers and inhibitors are aminoguanidine, camosine, and fex pyridoxamine.
  • the invention provides methods of wound healing comprising providing a subject having a wound and a composition comprising differentiable cells, differentiable cell or egg cellular extracts, egg extracts, components of cell extracts or egg extracts and applying the composition to the wound under conditions such that the wound is healed.
  • the composition further comprises a collagen dissolving agent.
  • the collagen dissolving agent is an acid.
  • the composition further comprises a fruit acid.
  • the composition is a cream.
  • the wound is an open wound and applying the composition topically.
  • the method further comprises providing a support matrix wherein, the support matrix comprises the composition.
  • the support matrix is a fabric or plastic wound dressing.
  • the invention provides methods of skin regeneration comprising providing a subject having a wound and a composition comprising differentiable cells, differentiable cell or egg cellular extracts, or components of cell extracts or egg extracts and applying the composition to the wound under conditions that such skin is regenerated.
  • the composition is a cream.
  • the wound is an open wound and applying the composition is topically.
  • the invention relates to a method of skin rejuvenation comprising providing a subject having an uneven skin and a composition comprising differentiable cells, differentiable cell or egg cellular extracts, egg extracts, or a component of a cellular extract and applying the composition to the uneven skin under conditions that such skin is rejuvenated.
  • the component of a cell extract is a nucleic acid sequence or the component of a cell extract is a peptide or combinations thereof.
  • the uneven skin is a result of a scar or wrinkles.
  • the composition is in a cream.
  • the cream further comprises permeabilizing agents.
  • the permeabilizing agent is a toxic agent, DMSO or chitosan, chitosan polymer, or trypsin.
  • the permeabilizing agent is liposomes or alginate beads.
  • the liposomes or alginate beads comprise a peptide or a nucleic acid sequence of a cell extract or growth factor or a combination thereof.
  • the liposome comprises nucleic acid sequence of cell extracts or egg extracts generated by electroporation.
  • the composition comprises a fusion trojan peptide comprising a peptide of the cell extract.
  • applying the composition is topical.
  • the method further comprises the step of applying the composition is executed after applying a chemical, laser, or physical force to the uneven skin under conditions that a outer lay of cells of the uneven skin are removed.
  • the composition further comprises an antiseptic, an antibacterial, an antiinflammatory, an immunomodulator, a protease, or an analgesics or combinations thereof.
  • the invention relates to a composition comprising: a lipid; a composition of plant seed components; an antioxidant; a purified or synthetic protein, or a purified or synthetic natural product contained in a cellular extract; a stabilizing component; autologous fat derived from adipose tissue of a subject.
  • the invention provides methods of improving a skin graft comprising grafting skin or skin substitute and applying a composition comprising: differentiable cells, differentiable cell or egg cellular extracts, egg extracts; components of cell extracts or egg extracts; a purified or synthetic nucleic acid sequence, a purified or synthetic protein, or a purified or synthetic natural product contain in cell extracts, egg extracts; or combinations thereof.
  • the invention provides methods for managing, treating, and/or preventing scarring, abnormal scars, abnormal wound healing, widened scar, hypertrophied scar, keloid, keloid scar, wound-healing complications, cicatrix, scar hypertrophy by administering in a prophylactic or non-prophylactic manner using compositions disclosed herein.
  • the invention provides methods for primary healing, wound closure, secondary healing, epithelialization, re-epithelialization, tertiary wound closure, delayed primary closure, debridement, suture, inflammatory phase, proliferative phase, maturational phase, hemostasis, inflammation, collagen, clotting, thromboxane A2, prostaglandin 2a, prostaglandin 2-alpha, vasoconstrictor, hemorrhage, vasodilatation, histamine, platelet, chemokine, epidermal growth factor, fibronectin, fibrinogen, histamine, platelet derived growth factor, serotonin, von Willebrand factor, clot formation, platelet degranulation, complement cascade, neutrophil, leukocyte, macrophage, monocyte, collagenase, interleukin, tumor necrosis factor, fibroblasts, transforming growth factor, keratinocyte, angiogenesis, granulation tissue formation, collagen deposition, and insulin-like growth
  • the invention provides compositions comprising differentiable cells, preferably embryonic stem cells or precursor cells.
  • the compositions comprises the extracts of differentiable cells, preferably embryonic stem cells or precursor cells.
  • the compositions contain components of extracts from differentiable cells, preferably embryonic stem cells or precursor cells.
  • the invention provides compositions containing differentiable cells, preferably embryonic stem cells or precursor cells, the extracts of differentiable cells, preferably embryonic stem cells or precursor cells, components of extracts from differentiable cells, and/or natural vernix and/or vemix extracts and/or vemix components of vemix extracts that partially or totally synthetic.
  • the invention provides methods for the topical administration of egg cellular extracts or differentiable cell cellular extracts comprising: providing a composition containing egg cellular extracts or differentiable cell cellular extracts and a subject having skin and applying the extracts to the skin.
  • a nutritional signal in the extract reaches and is effective as a nutrient to the skin cells.
  • the composition is in a water based gel comprising hyaluronic acid and/or chitosan.
  • the extract is a spray acting as a liquid band-aid or fluid that dries on the skin.
  • the liquid contains gel-forming components such as collagen and chitosan.
  • the composition is a component of a film on a support or cream.
  • the present invention also provides for use of the foregoing compositions for the treatment of skin, for removing wrinkles, for rejuvenation of skin, for wound healing, for improving the appearance of skin, the prevent damage to skin, to prevent deterioration of skin, or to provides nutrients to skin and any other use described herein.
  • the present invention further provides methods for preparing a composition for topical application to the skin comprising: providing differentiable cells or preparing an extract or fraction of differentiable cells or eggs; and formulating said differentiable cells or said extract with an agent for topical administration to the skin to provide a cream, gel, spray, emulsion, solid, plastic or matrix, ointment, powder or lotion suitable for topical administration.
  • the present invention provides compositions made by the foregoing methods. DESCRIPTION OF THE FIGURES
  • Figure 1 is a graph of generations over time.
  • Figure 2 is a graph of minutes/generation v. time.
  • Figure 3 is a growth curve graph.
  • Figure 4 provides graphs of mice skin wound and scar measurements measurements and wound healing rates. These data show that the wound healing extract has an effect on healing of two types of wounds (excision wounds left panels, incision wounds rights panels) in mouse skin. Measures taken by ruler and wound/scar area traced on transparent film at day 1, 5, 9 and 12. Areas of excision and length of incision wounds (top panels) show a gradual reduction in wound area from day 1 to 12. The healing starts earlier and the wound reduction is more rapid in extract treated animals, significant at day 5 and 9 for excision wounds. Scars formed were measured from day of reepitheilizatiori (middle panels). A tendency to smaller wound sizes is seen for both excision and incision wounds. Day of complete healing taken as day scab falls wound is revealed. The percent of animals with completely healed wounds (bottom panels) show more rapid healing in the treated animals for the incision wounds.
  • Anti-infective agents include, but are not limited to benzylpenicillin, penicillin, enicillin G, 6-phenyl acetyl penicillin, penicllin V, micronomicin, clavulanate, oxacillin, dequalinium, cloxacillin, sulbenicillin, ampicillin, cilleral, and devisn and combinations thereof.
  • Anti-inflammatory means a substance that reduces inflammation. Many analgesics remedy pain by reducing inflammation. Many steroids - specifically glucocorticoids - reduce inflammation by binding to Cortisol receptors. Non-steroidal anti-inflammatory drugs (NSAIDs) alleviate pain by counteracting the cyclooxygenase (COX) enzyme. On its own COX enzyme synthesizes prostaglandins, creating inflammation. Many herbs have anti-inflammatory qualities, including but not limited to hyssop and willow bark (the latter of which contains salicylic acid, the active ingredient in aspirin), as well as birch, licorice, wild yam and ginseng.
  • Antioxidants means any of a variety of substances that prevent or slow the breakdown of another substance by oxygen. Synthetic and natural antioxidants are used to slow the deterioration of gasoline and rubber, and such antioxidants as vitamin C (ascorbic acid), butylated hydroxytoluene (BHT), and butylated hydroxyanisole (BHA) are typically added to foods to prevent them from becoming rancid or from discoloring. Nutrients such as beta-carotene (a vitamin A precursor), vitamin C, vitamin E, and selenium have been found to act as antioxidants. They act by scavenging free radicals, molecules with one or more unpaired electrons, which rapidly react with other molecules, starting chain reactions in a process called oxidation.
  • Free radicals are a normal product of metabolism; the body produces its own antioxidants (e.g., the enzyme superoxide dismutase) to keep them in balance.
  • stress, aging, and environmental sources such as polluted air and cigarette smoke can add to the number of free radicals in the body, creating an imbalance.
  • the highly reactive free radicals can damage healthy DNA and have been linked to changes that accompany aging (such as age-related macular degeneration, a leading cause of blindness in older people) and with disease processes that lead to cancer, heart disease, and stroke.
  • an "antiseptic” is a substance that kills or prevents the growth and reproduction of various microorganisms, including bacteria, fungi, protozoa, and viruses on the external surfaces of the body.
  • the objective of antiseptics is to reduce the possibility of sepsis, infection or putrefaction by germs.
  • Antibacterials have the same objective but only act against bacteria.
  • Antibiotics perform a similar function, preventing the growth or reproduction of bacteria within the body.
  • Antiseptics include, but are not limited to, alcohol, iodine, hydrogen peroxide, and boric acid. There is great variation in the ability of antiseptics to destroy microorganisms and in their effect on living tissue.
  • mercuric chloride is a powerful antiseptic, but it irritates delicate tissue.
  • silver nitrate kills fewer germs but can be used on the delicate tissues of the eyes and throat.
  • Iodine one of the fastest- working antiseptics, kills bacteria within 30 sec.
  • Other antiseptics have slower, more residual action. Since so much variability exists, systems have been devised for measuring the action of an antiseptic against certain standards.
  • the bacteriostatic action of an antiseptic compared to that of phenol (under the same conditions and against the same microorganism) is known as its phenol coefficient.
  • Chitosan is a beta-1 ,4-linked glucosamine polymer which, unlike chitin, contains few, if any, N-acetyl residues. It may be obtained from chitin, a polysaccharide found in the exoskeletons of crustaceans such as shrimp, lobster, and crabs. The shells may be ground into a pulverous powder. This powder is then deacetylated which allows the chitosan to absorb lipids.
  • Collagen means any of a variety of substances that contains the alpha chains of the collagen polypeptide with a sequence that generally follows the pattern GIy-X-Y, where GIy for glycine, X for proline, and Y for proline or hydroxyproline. Collagen proteins also contain significant amounts of glycine and proline. Hydroxyproline and hydroxylysine are not inserted directly by ribosomes. They are derivatised from proline and lysine in enzymatic processes of post-translational modification, for which vitamin C is required.
  • fibroblasts form the various fibers in connective tissue in the body including collagen.
  • the white collagen that makes up the matrix of most connective tissue in mammals consists of inter- woven fibres of the protein collagen.
  • the collagen fibers consist of globular units of the collagen sub-unit, tropocollagen.
  • Tropocollagen sub-units spontaneously arrange themselves under physiological conditions into staggered array structures stabilized by numerous hydrogen and covalent bonds.
  • Tropocollagen sub-units are left-handed triple helices where each strand is, further, a right-handed helix itself.
  • tropocollagen may be considered to be a coiled coil.
  • collagen is responsible for skin elasticity, and its degradation leads to wrinkles that accompany aging, it occurs in many other places throughout the body, and in different forms known as types: Type I collagen - This is the most abundant collagen of the human body present in scar tissue, the end product when tissue heals by repair; Type II collagen - Auricular cartilage Type III collagen - This is the collagen of granulation tissue, and is produced quickly by young fibroblasts before the tougher type I collagen is synthesized; Type FV collagen - Basal lamina; Type V collagen - most interstitial tissue, assoc. with type I; Type VI collagen - most interstitial tissue, assoc.
  • Type II collagen - epithelia Type VII collagen - epithelia
  • Type VIII collagen some endothelial cells
  • Type IX collagen - cartilage assoc. with type II
  • Type X collagen - hypertrophic and mineralizing cartilage Type XI collagen - cartilage
  • Type XII collagen - interacts with types I and III.
  • collagen modulating substances means a variety of substances capable of facilitating the formation or breaking down of units or of any type of collagen.
  • a “gel” is a semisolid material formed from a colloidal solution. By weight, gels are mostly liquid, yet they behave like solids. An example is gelatin.
  • Keratin is any of a variety of fibrous protein molecules that serve as structural units for various living tissues.
  • the keratins are the major protein components of hair, wool, nails, horn, hoofs, and the quills of feathers. These proteins generally contain large quantities of the sulfur-containing amino acids, particularly cysteine.
  • the helical keratin molecules twist around each other to form elongated strands called intermediate filaments.
  • the formation of a disulfide bridge between the sulfur atoms on two cysteines on separate polypeptide chains of keratin allows for the cross-linkage of these chains and results in a fairly rigid aggregate.
  • Filaggrin is any of a variety of filament-associated proteins that interact with keratin intermediate filaments of terminally differentiating mammalian epidermis via disulphide bond formation.
  • Immunomodulator means any of a variety of substance that influences the immune system. Examples include, but are not limited to, cytokines, Interleukin-2, immunostimulants, and immunosuppressors.
  • natural product means any of a variety of organic chemical moieties whose molecular arrangement is derived from enzymatic transformations in a living organism excluding amino acids, proteins, polypeptides, nucleic acids and sequences, and saturated fatty acids. Examples include, but are not limited to lipids (i.e., that are not saturated fatty acids), carbohydrates/saccharides and polysaccharides, the steroids and their derivatives, the terpenes and their derivatives, vitamins, carotenoids, and natural medicines such as taxol, etc.
  • synthetic natural product is a natural product not obtained from its natural source.
  • gene refers to a DNA sequence that comprises control and coding sequences necessary for the production of a polypeptide or protein precursor.
  • the polypeptide can be encoded by a full length coding sequence or by any portion of the coding sequence, as long as the desired protein activity is retained.
  • Nucleoside refers to a compound consisting of a purine [guanine (G) or adenine (A)] or pyrimidine [thymine (T), uridine (U), or cytidine (C)] base covalently linked to a pentose, whereas “nucleotide” refers to a nucleoside phosphorylated at one of its pentose hydroxyl groups.
  • Nucleic acid sequence refers to an oligonucleotide, nucleotide or polynucleotide, and fragments or portions thereof, and to DNA or RNA of genomic or synthetic, origin that may be single- or double-stranded, and represent the sense or antisense strand.
  • An "amino acid sequence” as used herein refers to a peptide or protein sequence.
  • a "peptide nucleic acid” as used herein refers to an oligomeric molecule in which nucleosides are joined by peptide, rather than phosphodiester, linkages. These small molecules, also designated anti-gene agents, stop transcript elongation by binding to their complementary (template) strand of nucleic acid (Nielsen et al. (1993) Anticancer Drug Des., 8:53-63).
  • a “variant” in regard to amino acid sequences is used to indicate an amino acid sequence that differs by one or more amino acids from another, usually related amino acid.
  • the variant may have "conservative” changes, wherein a substituted amino acid has similar structural or chemical properties (e.g., replacement of leucine with isoleucine). More rarely, a variant may have "non-conservative" changes, e.g., replacement of a glycine with a tryptophan. Similar minor variations may also include amino acid deletions or insertions (i.e., additions), or both.
  • Guidance in determining which and how many amino acid residues may be substituted, inserted or deleted without abolishing biological or immunological activity may be found using computer programs well known in the art, for example, DNAStar software.
  • portion in reference to an amino acid sequence or a protein (as in “a portion of an amino acid sequence”) refers to fragments of that protein. The fragments may range in size from four amino acid residues to the entire amino acid sequence minus one amino acid.
  • purified refers to molecules, including but not limited to nucleic, ribonucleic, lipid or amino acid sequences, which are removed from their natural environment, isolated or separated. An “isolated nucleic acid sequence” is therefore a purified nucleic acid sequence. “Substantially purified” molecules are at least 60% free, preferably at least 75% free, and more preferably at least 90% free from other components with which they are naturally associated.
  • Cancer means any of various cellular diseases with malignant neoplasms characterized by the proliferation of anaplastic cells. It is not intended that the diseased cells must actually invade surrounding tissue and metastasize to new body sites. Cancer can involve any tissue of the body and have many different forms in each body area. Most cancers are named for the type of cell or organ in which they start.
  • Cell means the smallest structural unit of living matter capable of functioning autonomously, consisting of one or more nuclei, cytoplasm, and various organelles, all surrounded by a semipermeable membrane.
  • Cells include all somatic cells obtained or derived from a living or deceased animal body at any stage of development as well as germ cells, including sperm and eggs (animal reproductive body consisting of an ovum or embryo together with nutritive and protective envelopes). Included are both general categories of cells: prokaryotes and eukaryotes.
  • the cells contemplated for use in this invention include all types of cells from all organisms in all kingdoms: plans, animals, protists, fungi, archaebacteria and eubacteria.
  • Stem cells are cells capable, by successive divisions, of producing specialized cells on many different levels. For example, hematopoietic stem cells produce both red blood cells and white blood cells. From conception until death, humans contain stem cells, but in adults their power to differentiate is reduced.
  • differentiation related to cells means the process by which cells becomes structurally and functionally specialized, which is a progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs.
  • dedifferentiation related to cells means the reverse process of differentiation, where cells become less structurally and functionally specialized, which increases the developmental potential of the cell.
  • “Differentiable” means the ability of a cell to differentiate into a desired cell type.
  • the term “differentiates” means specialization (differentiation) or return to a more primitive cell type; dedifferentiation).
  • Extract as used in the context of "cell extract” and “egg extract” in this invention means a preparation of any type of cell as defined above obtained by chemical or mechanical action, as by pressure, distillation, evaporation etc. Extracts can include all or any single component or combination of components of the cells, including concentrated preparations of the active components. Such components of the extracts include but are not limited to RNA, DNA, lipids, all amino acid base structures including peptides and proteins, carbohydrates or combinations thereof. Extracts contemplated by this invention include but are not limited to extracts offish eggs, urchin eggs, frog eggs, adult stem cells, plant seeds and plant stem cells.
  • “Growth media” are compositions used to grow microorganisms or cells in culture. There are different sorts of media for growing different sorts of cells. The biggest difference in growth media are between those used for growing cells in culture (cell culture uses specific cell types derived from plants or animals) and those used for growing microorganisms (usually bacteria or yeast). These differences arise due to the fact that cells derived from whole organisms and grown in culture are often incapable of growth without the provision of certain requirements, such as hormones or growth factors which usually occur in vivo. In the case of animal cells these requirements are often provided by the addition of blood serum to the medium. These media are often red or pink due to the inclusion of pH indicators.
  • Growth media for embryonic stem cells preferably contains minimal essential medium, i.e., Eagle's: amino acids, salts (Ferric nitrate nonahydrate, Potassium chloride, Magnesium sulfate, Sodium chloride, Sodium dihydrogen phosphate), vitamins, (Ascorbic acid, Folic acid, Nicotinamide, Riboflavin, B-12) or Dulbecco's: additionally iron, glucose; non-essential amino acids, sodium pyruvate, ⁇ -mercaptoethanol, L-glutamine, fetal bovine serum and Leukemia Inhibitory Factor (LIF).
  • minimal essential medium i.e., Eagle's: amino acids, salts (Ferric nitrate nonahydrate, Potassium chloride, Magnesium sulfate, Sodium chloride, Sodium dihydrogen phosphate), vitamins, (Ascorbic acid, Folic acid, Nicotinamide, Riboflavin, B-12) or Dulbecco
  • Bacteria such as Escherichia coli may be grown on solid media or in liquid media, liquid nutrient medium is commonly called nutrient broth.
  • liquid nutrient medium is commonly called nutrient broth.
  • the preferred growth media for microorganisms are nutrient broth or Luria-Bertani medium (L-B medium).
  • Bacteria grown in liquid cultures often form colloidal suspensions.
  • agar a substance which sets into a gel
  • Petri dishes where it will solidify (these are called agar plates) and provide a solid medium on which microbes may be cultured.
  • to glue to skin means to stick or fasten to with or as if with any of various adhesives, such as, glue, paste or mucilage.
  • a "lipid” means any of a group of organic compounds, including the fats, oils, waxes, sterols, and triglycerides that are insoluble in water but soluble in nonpolar organic solvents, and are oily to the touch.
  • lipids include the fatty acids, the glycerol -derived lipids (including the fats and oils and the phospholipids), the sphingosine- derived lipids (including the ceramides, cerebrosides, gangliosides, and sphingomyelins), the steroids and their derivatives, the terpenes and their derivatives, certain aromatic compounds, and long-chain alcohols and waxes.
  • lipids serve as the basis of cell membranes and as a form of fuel storage. Often lipids are found conjugated with proteins or carbohydrates, and the resulting substances are known as lipoproteins and lipopolysaccharides.
  • the fat-soluble vitamins can be classified as lipids.
  • Liposomes are spherical vesicles formed by mixing lipids with water or water solutions. They have found applications in the oral administration of some drugs (e.g., insulin and some cancer drugs), since they retain their integrity until they are broken down by the lipases in the stomach and small intestine.
  • some drugs e.g., insulin and some cancer drugs
  • a "nutrient gel layer” a gel comprising substances typically contained in a growth medium.
  • specialized cell of a subject means that the cell has characteristic immunoidenificative markers, such that differentiation of these cells and exposure to tissues of the subjects can be done under conditions such that immune system does not create antibodies to the differentiated cells. For example, when red blood cells carrying one or both A or B antigens are exposed to the corresponding antibodies, they agglutinate; that is, clump together. People usually have antibodies against those red cell antigens that they lack. Thus, specialized red blood cells of the subject would be those of the proper blood type. The cause of transplant rejection is recognition of foreign MHC antigens by T cells and activation of those T cells to become effector cytotoxic or helper T cells.
  • T cell activation occurs in the case of vascularized grafts of nucleated cells expressing MHC Matching MHC Class I (especially HLA-B) and Class II HLA-DR alleles is more important for successful transplantation than matching other MHC antigens; and matching MHC is more important than matching minor histocompatibility antigens.
  • MHC Matching MHC Class I (especially HLA-B) and Class II HLA-DR alleles is more important for successful transplantation than matching other MHC antigens; and matching MHC is more important than matching minor histocompatibility antigens.
  • specialized MHC presenting cells of the subject would be those presenting matching MHC alleles.
  • a subject when used in connection with a disease or condition means to provide beneficial effects to a subject being administered with a prophylactic or therapeutic agent, which does not result in a cure of the disease.
  • a subject is administered with one or more prophylactic or therapeutic agents to manage a disease so as to prevent the progression or worsening of the disease.
  • the terms “prevent” and “preventing” include the prevention of the recurrence, spread or onset. It is not intended that the present invention be limited to complete prevention. In some embodiments, the onset is delayed, or the severity of the disease is reduced.
  • the terms “treat” and “treating” are not limited to the case where the subject (e.g. patient) is cured and the disease is eradicated. Rather, the present invention also contemplates treatment that merely reduces symptoms, and/or delays disease progression.
  • a "waterproof layer” means a material or fabric that is substantially impervious to water or a layer of a sealing agent to intended to prevent substantial penetration by water.
  • transport vehicle includes substances capable of aiding penetration of intact skin or skin cells or other somatic cells.
  • transport vehicle is used synonymously with the term “permeabilizing agents”.
  • Such transport vehicles include, but are not limited to: phospholipids, palmitylmyristyrates, DMSO, polymer or chitosan suspensions or matrix, liposomes, Trojan peptides, chariot peptides, small elastic vesicles, microspheres (functionalized vectors made from naturally derived materials such as collagen, glycosaminoglycans, chondroitin sulfate, chitosan or polysaccharides), nanoparticles (carries lipophilic substances and enhance bioavailability of the encapsulated material into skin), preloaded spherical beads and sponges, uni- and/or multilamellar vesicles (stabilize contents of extracts in cream base and help transport into skin), retinol molecular film fluid (thin uniform monolayer film
  • NANOG refers to a homeobox gene. NANOG is thought to be required for stem cells to multiply without limit while remaining able to make many different types of cells.
  • the gene is a potential master gene that helps make embryonic stem cells grow in the laboratory, making stem cells immortal.
  • OCT4 refers to a gene that is not active in somatic cells, including adult stem cells, but is expressed in embryonic stem and germ cells. OCT4 is essential to maintain pluripotency of embryonic stem cells.
  • SOX2 refers to the sex determining region Y (SRY) box
  • This intronless gene encodes a member of the SRY-related HMG- box (SOX) family of transcription factors involved in the regulation of embryonic development and in the determination of cell fate.
  • SOX SRY-related HMG- box
  • GPDH refers to the housekeeping gene glyceraldehydes-3-phosphate dehydrogenase. This gene is involved in basic functions needed for cell maintenance. Housekeeping genes are constitutively expressed.
  • the invention relates to improving health and damage of cells and tissues preferably skin, and more preferably restoring aged or damaged skin to a youthful and healthy appearance.
  • the invention relates to compositions of cells, cell or egg extracts, and extract components which can induce differentiation, including but not limited to purified or synthetic nucleic acid sequences, polypeptides, or natural products contained in said extracts.
  • the cells are differentiable cells, preferably stem cells or eggs.
  • the extracts are aqueous extracts.
  • the extracts are from a non-avian source.
  • compositions are used in a method that comprises application of compositions to skin and/or wounds after removal the outer surface layers.
  • the invention related to a method of dedifferentiation of cells and/or dedifferentiation followed by redifferentiation.
  • the invention relates to managing, preventing, and treating skin diseases.
  • compositions to the desired surface may be prophylactic, so that the composition is applied to the skin or other surface before exposure to an agent occurs.
  • Application of the composition may be curative, for example, to further protect a compromised skin surface or to provide a protectant surface during natural or mediated healing of an exposed skin surface.
  • Application of the composition may be protective, for example, to protect a skin surface should exposure to the agent occur.
  • the present invention relates to the use of extracts or components of differentiable cells for topical application to surfaces of the body. Accordingly, the present invention provides methods and compositions for cosmetic and therapeutic uses. The present invention is not limited to the use of extracts or components of any particular type of differentiatable cell.
  • mammalian embryonic stem cells including, but not limited to, mammalian embryonic stem cells, mammalian adult stem cells, cord blood cells, fish, shrimp or sea urchin eggs and embryos, and amphibian eggs and embryos.
  • the invention relates to dedifferentiating existing epithelial/epidermal cells to a primordial state, wherein the cells have stem-cell capacities and can reform the correct and needed cells for the regeneration of the whole layer of skin (epidermis, dermis and subdermis).
  • the cells have stem-cell capacities and can reform the correct and needed cells for the regeneration of the whole layer of skin (epidermis, dermis and subdermis).
  • differentiated cells are typically committed to their fate, dedifferentiation events can take place.
  • Urodele amphibians and teleost fish can replace lost anatomical parts by a process of migration, dedifferentiation, proliferation and redifferentiation of epithelial cells in the wounded area.
  • Functional reprogramming of differentiated cell nuclei has also been illustrated by the derivation of pluripotent embryonic stem cells (ESCs), and by the live birth of cloned animals after nuclear transplantation into unfertilized eggs.
  • ESCs pluripotent embryonic stem cells
  • plasticity means that a cell from one tissue can generate the differentiated cell types of another tissue.
  • Xenopus eggs can reprogram mammalian somatic nuclei to express the POU family member homeodomain transcription factor gene Oct4 by a process requiring DNA demethylation.
  • DNA demethylation also occurs after fusion of mouse thymocytes with embryonic germ cells (EGCs) but interestingly, only EG cells are capable of demethylating imprinted genes. Fusion of neuronal progenitor cells or bone marrow derived cells with ESCs results in hybrids which express markers of pluripotency. Similar results are obtained from fusing human fibroblasts with ESCs.
  • Fusion of embryonal carcinoma cells (ESCs) with T-lymphoma cells also promotes the formation of colonies expressing pluripotent cell transcripts from the lymphoma genome.
  • Components of pluripotent EG, ES or EC cells can elicit reprogramming events in a somatic genome.
  • Somatic nuclear function can be altered using nuclear and cytoplasmic extracts because extracts provide the necessary regulatory components. Extracts of regenerating newt limbs promote cell cycle reentry and downregulation of myogenic markers in differentiated myotubes.
  • Teratocarcinomas are a particular type of germ cell tumors which contain undifferentiated stem cells and differentiated derivatives that can include endoderm, mesoderm and ectoderm germ layers. Undifferentiated carcinoma cells can be cultured to give rise to lines of ECCs. ECCs form malignant teratocarcinomas when transplanted into ectopic sites; however, some ECC lines can also contribute to tissues of the developing fetus when introduced into a blastocyst.
  • Undifferentiated human teratocarcinoma NCCIT cells can be established from a mediastinal mixed germ cell tumor.
  • NCCIT is at a stage intermediate between a seminoma (a precursor of germ cell tumors) and an embryonal carcinoma.
  • NCCIT is a developmentally pluripotent cell line that can differentiate into derivatives of all three embryonic germ layers and extraembryonic cell lineages an extract of undifferentiated somatic cells can elicit dedifferentiation in a somatic cell line. See Taranger et al., "Induction of Dedifferentiation, Genome-wide Transcriptional Programming, and Epigenetic Reprogramming by Extracts of Carcinoma and Embryonic Stem Cells" MoI Biol Cell. (2005).
  • Stem cells can establish in damaged tissue. See Menard et al., "Transplantation of cardiac-committed mouse embryonic stem cells to infarcted sheep myocardium: a preclinical study" Lancet, 366(9490): 1005- 12 (2005); Goldman “Stem and progenitor cell- based therapy of the human central nervous system” Nat Biotechnol. 23(7): 862-71 (2005); Leri et al., “Repair of the damaged heart” Kidney Int. 68(5):1962 (2005); Levy et al.,
  • the invention relates to extracts that are capable of stimulating the immune system to aid in healing.
  • the extracts may contain fibrogen and heat shock proteins. These endogenous cellular components are alarm signals typically expressed in distressed or injured cells. They bind Toll-like receptors (TLRs) in antigen presenting cells (APCs) and put the immune system on alert of a damaged area. See Matzinger "The Danger Model: A Renewed Sense of Self Science 296:301-305 (2002).
  • the invention relates to stimulating existing stem cells in skin, such as stem cells found in and around hair follicles to duplicate and/or differentiate into epithelial cells or neurons.
  • Nestin a marker for neural progenitor cells, is expressed in cells of the hair-follicle bulge and behave as stem cells, differentiating to form much of the hair follicle during each hair growth cycle.
  • the hair follicle is dynamic, cycling between growth (anagen), regression (catagen), and resting (telogen) phases throughout life.
  • Stem cells located in the hair-follicle bulge area give rise to the follicle structures during each anagen phase.
  • Bulge hair-follicle stem cells can generate all epithelial cell types within the intact follicle and hair during normal hair-follicle cycling.
  • the bulge hair-follicle stem cells differentiate into hair-follicle matrix cells, sebaceous-gland basal cells, and epidermis.
  • Multipotent adult stem cells from the skin dermis termed skin-derived precursors (SKPs)
  • SBPs skin-derived precursors
  • Pluripotent neural crest stem cells are present in the dermal papillae of adult mammalian hair follicles. See Amoh et al., "Multipotent nestin- positive, keratin-negative hair-follicle bulge stem cells can form neurons" Proc Natl Acad Sci U S A. 12;102(15):5530-4 (2005).
  • the bone marrow contains three stem cell populations — hematopoietic stem cells, stromal cells, and endothelial progenitor cells.
  • Bone marrow stem cells the hematopoietic stem cells (HSCs)
  • HSCs hematopoietic stem cells
  • the bone marrow-derived cells are sometimes sorted — using a panel of surface markers — into populations of hematopoietic stem cells or bone marrow stromal cells.
  • the HSCs may be highly purified or partially purified, depending on the conditions used. Another way to separate population of bone marrow cells is by fractionation to yield cells that adhere to a growth substrate (stromal cells) or do not adhere (hematopoietic cells).
  • the mesenchymal stem cells of the bone marrow also give rise to these tissues, and constitute the same population of cells as the bone marrow stromal cells.
  • Progenitor cells that differentiates into endothelial cells a type of cell that lines the blood vessels, can be isolated from circulating blood.
  • Pericytes are related to bone marrow stromal cells.
  • Combinations of surface markers are used to identify, isolate, and purify HSCs derived from bone marrow and blood.
  • Undifferentiated HSCs and hematopoietic progenitor cells express c-kit, CD34, and H-2K. These cells usually lack the lineage marker Lin, or express it at very low levels (Lin-/low).
  • BM stromal cells have several features that distinguish them from HSCs.
  • BM stromal cells form colonies from a single cell called the colony forming unit-F (CFU-F). These colonies may then differentiate as adipocytes or myelo supportive stroma, a clonal assay that indicates the stem cell-like nature of stromal cells.
  • CFU-F colony forming unit-F
  • Endothelial stem cells are CD34+ (a marker for HSCs), and they express the transcription factor GATA-2 see Kocher, et al., "Neovascularization of ischemic myocardium by human bone-marrow-derived angioblasts prevents cardiomyocyte apoptosis, reduces remodeling and improves cardiac function" Nat. Med. 7, 430-436 (2001).
  • the present invention contemplates the use of any type of cell including stem cells from any multicellular organism in any kingdom of species, both eukaryotes including animals, plants, protists, fungi, and prokaryotes including the kingdoms archaebacteria and eubacteria.
  • Multicellular organisms contain totipotent, mulitpotent, pluripotent and unipotent stem cells capable of dividing and replenishing tissues and cells which compose the organism.
  • Stem cells are well documented in mammalian animals, but are present in all animals, e.g. insects.
  • Adult fruit flies have the same stem cells controlling cell regulation in their gut as humans do. Vertebrate and invertebrate digestive systems show extensive similarities in their development, cellular makeup and genetic control.
  • the Drosophila midgut is typical: enterocytes make up the majority of the intestinal epithelial monolayer, but are interspersed with hormone-producing enteroendocrine cells.
  • Human (and mouse) intestinal cells are continuously replenished by stem cells, the misregulation of which may underlie some common digestive diseases and cancer.
  • stem cells have not been described in the intestines of flies, and Drosophila intestinal cells have been thought to be relatively stable.
  • ISCs intestinal stem cells
  • plants also contain stem cells.
  • Stem cells in plant shoot and root meristems are maintained throughout the life of the plant and produce somatic daughter cells that make up the body of the plant.
  • Plant stem cells can also be derived from somatic cells in vivo and in vitro. (Plants stem cells: divergent pathways and common themes in shoots and roots. Byrne ME, Kidner CA, Martienssen RA. Curr Opin Genet Dev.
  • Plants move, conduct cell divisions which serve to regenerate and maintain tissues and circulating cell populations, grow in a concurrently repetitive manner, contain a reserved germline set aside in embryogeny, have a low tolerance to genetic abnormalities, produce embryos complex and incomplete, and display essentially no asexual propagation and have no cell wall. Plants respond by physiological adjustment, their cell divisions contribute to de novo formation of organs all the way through to senescence, plant growth is serial, repetitive, and plastic, plants have no reserved germline, are more tolerant of genetic abnormalities, their embryos simple and complete, and plant cells are totipotent. Plant stem cells and seeds (plant gametes) are contemplated for use in this invention.
  • the present invention provides compositions comprising embryonic stem cells or extracts prepared from embryonic stem cells.
  • the cells or extracts are formulated for topical application as described in more detail below.
  • the present invention is not limited to the use of any particular type of embryonic stem cells. Indeed, the use of embryonic stem cells from a number of animal species is contemplated, including all species in the animal kingdom, but not limited to invertebrates and vertebrates, including species in the phylum chordata, including all classes, and importantly all orders of the class mammalia, including but not limited to all primates, rodents, carnivores, lagomorphs and artiodactyles.
  • Primate embryonic stem cells may be preferably obtained by the methods disclosed in U.S. Pat. Nos. 5,843,780 and 6,200,806, each of which is incorporated herein by reference. Primate (including human) stem cells may also be obtained from commercial sources such as WiCeIl, Madison, WI.
  • a preferable medium for isolation of embryonic stem cells is "ES medium.”
  • ES medium consists of 80% Dulbecco's modified Eagle's medium (DMEM; no pyruvate, high glucose formulation, Gibco BRL), with 20% fetal bovine serum (FBS; Hyclone), 0.1 mM ⁇ -mercaptoethanol (Sigma), 1% non-essential amino acid stock (Gibco BRL).
  • fetal bovine serum batches are compared by testing clonal plating efficiency of a low passage mouse ES cell line (ESj t3 ), a cell line developed just for the purpose of this test.
  • FBS batches must be compared because it has been found that batches vary dramatically in their ability to support embryonic cell growth, but any other method of assaying the competence of FBS batches for support of embryonic cells will work as an alternative.
  • ES cells are isolated on a confluent layer of murine embryonic fibroblast in the presence of ES cell medium.
  • Embryonic fibroblasts are preferably obtained from 12 day old fetuses from outbred CFl mice (SASCO), but other strains may be used as an alternative.
  • Tissue culture dishes are preferably treated with 0.1% gelatin (type I; Sigma). Recovery of rhesus monkey embryos has been demonstrated, with recovery of an average 0.4 to 0.6 viable embryos per rhesus monkey per month, Seshagiri et al. Am J Primatol 29:81-91, 1993. Embryo collection from marmoset monkey is also well documented (Thomson et al.
  • blastocysts are exposed to a 1 :50 dilution of rabbit anti -marmoset spleen cell antiserum (for marmoset blastocysts) or a 1 :50 dilution of rabbit anti-rhesus monkey (for rhesus monkey blastocysts) in DMEM for 30 minutes, then washed for 5 minutes three times in DMEM, then exposed to a 1 :5 dilution of Guinea pig complement (Gibco) for 3 minutes.
  • rabbit anti -marmoset spleen cell antiserum for marmoset blastocysts
  • rabbit anti-rhesus monkey for rhesus monkey blastocysts
  • lysed trophectoderm cells are removed from the intact inner cell mass (ICM) by gentle pipetting, and the ICM plated on mouse inactivated (3000 rads gamma irradiation) embryonic fibroblasts.
  • ICM-derived masses are removed from endoderm outgrowths with a micropipette with direct observation under a stereo microscope, exposed to 0.05% Trypsin-EDTA (Gibco) supplemented with 1% chicken serum for 3-5 minutes and gently dissociated by gentle pipetting through a flame polished micropipette. Dissociated cells are replated on embryonic feeder layers in fresh ES medium, and observed for colony formation.
  • ES-like morphology Colonies demonstrating ES-like morphology are individually selected, and split again as described above.
  • the ES-like morphology is defined as compact colonies having a high nucleus to cytoplasm ratio and prominent nucleoli. Resulting ES cells are then routinely split by brief trypsinization or exposure to Dulbecco's Phosphate Buffered Saline (without calcium or magnesium and with 2 mM
  • extracts are prepared from the mammalian embryonic stem cells.
  • cells are washed in phosphate buffered saline (PBS) and in cell lysis buffer (100 mM HEPES, pH 8.2, 50 mM NaCl, 5 mM MgCl 2 , 1 mM dithiothreitol and protease inhibitors), sedimented at 400 g, resuspended in 1 volume of cold cell lysis buffer and incubated for 30-45 min on ice to allow swelling.
  • Cells are sonicated on ice in 200- ⁇ l aliquots using a Labsonic-M pulse sonicator fitted with a 3-mm diameter probe (B.
  • the animal stem cell extracts including but not limited to mammalian stem cell extracts, are used as is, while in other embodiments, the extracts are formulated either alone or with other components as described in more detail below.
  • the present invention provides compositions comprising adult stem cells or extracts prepared from adult stem cells.
  • the cells or extracts are formulated for topical application as described in more detail below.
  • the adult stem cell is an undifferentiated (unspecialized) cell that is found in a differentiated (specialized) tissue; it can renew itself and become specialized to yield specialized cell types of the tissue from which it originated.
  • These precursor cells exist within the differentiated tissues of the adult of all multicellular organisms in the animal, plant, protist and fungi kingdoms as a community of cells dispersed throughout the tissue.
  • Precursor cells derived from adults can be divided into three categories based on their potential for differentiation.
  • precursor cells are epiblast-like stem cells, germ layer lineage stem cells, and progenitor cells.
  • Precursor cells have been isolated from a wide variety of tissues, including, but not limited to, skeletal muscle, dermis, fat, cardiac muscle, granulation tissue, periosteum, perichondrium, brain, meninges, nerve sheaths, ligaments, tendons, blood vessels, bone marrow, trachea, lungs, esophagus, stomach, liver, intestines, spleen, pancreas, kidney, urinary bladder, and testis.
  • Precursor cells can be released from the connective tissue compartments throughout the body by mechanical disruption and/or enzymatic digestion and have been isolated from, but not limited to, newborns, adolescent, and geriatric mice, rats and humans, and adult rabbits, dogs, goats, sheep, and pigs.
  • the first category of precursor cells epiblast-like stem cells (ELSCs), consists of a stem cell that will form cells from all three embryonic germ layer lineages. Stem cells from adult rats and stem cells from adult humans can be released from the connective tissue compartments throughout the body by mechanical disruption and/or enzymatic digestion.
  • the stem cells from either adult rats or adult humans can be preferentially slow frozen and stored at -80 0 C ⁇ 5°C using 7.5% ultra-pure dimethyl sulfoxide. Fast thawing of stem cells from both species from the frozen state to ambient temperature yields recovery rates exceeding 98%. These cells in the undifferentiated state express the Oct-3/4 gene that is characteristic of embryonic stem cells.
  • ELSCs do not spontaneously differentiate in a serum free environment lacking progression agents, proliferation agents, lineage-induction agents, and/or inhibitory factors, such as recombinant human leukemia inhibitory factor (LIF), recombinant murine leukemia inhibitory factor (ESGRO), or recombinant human anti-differentiation factor (ADF). Embryonic stem cells spontaneously differentiate under these conditions. In contrast, ELSCs derived from both species remain quiescent unless acted upon by specific proliferative and/or inductive agents and/or environment.
  • LIF human leukemia inhibitory factor
  • ESGRO
  • ELSCs proliferate to form multiple confluent layers of cells in vitro in the presence of proliferation agents such as platelet-derived growth factors and respond to lineage- induction agents.
  • ELSCs respond to hepatocyte growth factor by forming cells belonging to the endodermal lineage.
  • Cell lines have expressed phenotypic markers for many discrete cell types of ectodermal, mesodermal, and endodermal origin when exposed to general and specific induction agents.
  • the second category of precursor cells consists of three separate stem cells. Each of the cells forms cells of a specific embryonic germ layer lineage (ectodermal stem cells, mesodermal stem cells and endodermal stem cells). When exposed to general and specific inductive agents, germ layer lineage ectodermal stem cells can differentiated into, for example, neuronal progenitor cells, neurons, ganglia, oligodendrocytes, astrocytes, synaptic vesicles, radial glial cells, and keratinocytes.
  • germ layer lineage ectodermal stem cells can differentiated into, for example, neuronal progenitor cells, neurons, ganglia, oligodendrocytes, astrocytes, synaptic vesicles, radial glial cells, and keratinocytes.
  • the third category of precursor cells present in adult tissues is composed of a multitude of multipotent, tripotent, bipotent, and unipotent progenitor cells. In solid tissues these cells are located near their respective differentiated cell types. Progenitor cells do not typically display phenotypic expression markers for pluripotent ELSCs, such as stage specific embryonic antigen-4, stage- specific embryonic antigen- 1 or stage-specific embryonic antigen-3, or carcinoembryonic antigen cell adhesion molecule- 1. Similarly, progenitor cells do not typically display phenotypic expression markers for germ layer lineage stem cells, such as nestin for cells of the ectodermal lineage or fetoprotein for cells of the endodermal lineage.
  • phenotypic expression markers for pluripotent ELSCs such as stage specific embryonic antigen-4, stage- specific embryonic antigen- 1 or stage-specific embryonic antigen-3, or carcinoembryonic antigen cell adhesion molecule- 1.
  • a progenitor cell may be multipotent, having the ability to form multiple cell types.
  • a precursor cell of ectodermal origin residing in the adenohypophysisand designated the adenohypophyseal progenitor cell is an example of a multipotent progenitor cell. This cell will form gonadotrophs, somatotrophs, thyrotrophs, corticotrophs, and mammotrophs.
  • Progenitor cells for particular cell lineages have unique profiles of cell surface cluster of differentiation (CD) markers and unique profiles of phenotypic differentiation expression markers. Progenitor cells do not typically spontaneously differentiate in serum-free defined medium in the absence of a differentiation agent, such as LIF or ADF.
  • progenitor cells remain quiescent unless acted upon by proliferative agents (such as platelet-derived growth factor) and/or progressive agents (such as insulin, insulin-like growth factor-I or insulin-like growth factor-II).
  • proliferative agents such as platelet-derived growth factor
  • progressive agents such as insulin, insulin-like growth factor-I or insulin-like growth factor-II.
  • Progenitor cells can regulate their behavior according to changing demands such that after transplantation they activate from quiescence to proliferate and generate both new satellite cells and substantial amounts of new differentiated cells.
  • the contractile units of muscle are myofibers, elongated syncytial cells each containing many hundreds of postmitotic myonuclei. Satellite cells are resident beneath the basal lamina of myofibers and function as myogenic precursors during muscle regeneration. In response to muscle injury, satellite cells are activated, proliferate, and differentiate, during which they fuse together to repair or replace damaged myofibers.
  • satellite cells When satellite cells are removed from their myofibers by a non-enzymatic physical titration method, they retain their ability to generate substantial quantities of new muscle after grafting that they are not able to attain by enzymatic digestion. Conventional enzymatic disaggregation techniques impair myogenic potential. Collins and Partridge "Self-Renewal of the Adult Skeletal Muscle Satellite Cell” Cell Cycle 4:10, 1338-1341 (2005).
  • MSCs mesenchymal stem cells
  • marrow, periosteum, dermis and other tissues of mesodermal origin See, e.g., U.S. Pat. Nos. 5,591,625 and 5,486,359, each of which is incorporated herein by reference).
  • MSCs are the formative pluripotential blast cells that differentiate into the specific types of connective tissues (i.e.
  • lymphoid lineage comprising B-cells and T-cells, provides for the production of antibodies, regulation of the cellular immune system, detection of foreign agents in the blood, detection of cells foreign to the host, and the like.
  • the myeloid lineage which includes monocytes, granulocytes, megakaryocytes as well as other cells, monitors for the presence of foreign bodies in the blood stream, provides protection against neoplastic cells, scavenges foreign materials in the blood stream, produces platelets, and the like.
  • the erythroid lineage provides the red blood cells, which act as oxygen carriers.
  • the present invention also contemplates the use of neural stem cells, which are generally isolated from developing fetuses.
  • the isolation, culture, and use of neural stem cells are described in U.S. Pat. Nos. 5,654,183; 5,672,499; 5,750,376; 5,849,553; and 5,968,829, all of which are incorporated herein by reference.
  • the methods of the present invention can use neural stem cells to produce neurons, glia, melanocytes, cartilage and connective tissue of the head and neck, stroma of various secretory glands and cells in the outflow tract of the heart.
  • extracts are prepared from the mammalian embryonic stem cells.
  • cells are. washed in phosphate buffered saline (PBS) and in cell lysis buffer (100 mM HEPES, pH 8.2, 50 mM NaCl, 5 mM MgCl 2 , 1 mM dithiothreitol and protease inhibitors), sedimented at 400 g, resuspended in 1 volume of cold cell lysis buffer and incubated for 30-45 min on ice to allow swelling.
  • Cells are sonicated on ice in 200- ⁇ l aliquots using a Labsonic-M pulse sonicator fitted with a 3 -mm diameter probe (B.
  • the adult stem cell extracts are used as is, while in other embodiments, the extracts are formulated either alone or with other components as described in more detail below.
  • the present invention provides compositions comprising cord blood cells or extracts prepared from cord blood cells.
  • the cells or extracts are formulated for topical application as described in more detail below.
  • cord blood as a source of hematopoietic stem cells for transplantation.
  • the proliferative capacity of hematopoietic stem cells in cord blood is superior to that of cells in marrow or blood from adults. Because they proliferate rapidly, the stem cells in a single unit of cord blood can reconstitute the entire hematopoietic system.
  • the use of cord blood reduces the risk of graft- versus-host disease, the main obstacle to the success of allogeneic transplantation of hematopoietic stem cells.
  • Graft- versus-host disease is caused by a reaction of T cells in the graft to HLA antigens in the recipient; the immaturity of lymphocytes in cord blood dampens that reaction.
  • a joint European study showed that recipients of cord blood from HLA-identical siblings had a lower risk of acute or chronic graft- versus-host disease than recipients of marrow from HLA-identical siblings.
  • Children with acute leukemia who received HLA- mismatched cord blood from an unrelated donor also had a lower risk of graft-versus-host disease than recipients of HLA-mismatched marrow from an unrelated donor
  • Cord blood cells from siblings or children with matching HLA could be used to make extracts or be applied for the use as contemplated by this invention.
  • compositions of the present invention utilize cell, egg and embryo extracts from vertebrates, including but not limited to Superclass Gnathostomata (jawed vertebrates), Euteleostomi (bony vertebrates), Class Actinopterygii (ray-finned fishes), Class Sarcopterygii (lobe-finned fishes and terrestrial vertebrates), Tetrapoda .
  • vertebrates including but not limited to Superclass Gnathostomata (jawed vertebrates), Euteleostomi (bony vertebrates), Class Actinopterygii (ray-finned fishes), Class Sarcopterygii (lobe-finned fishes and terrestrial vertebrates), Tetrapoda .
  • unfertilized but activated fish, shrimp, sea urchin or amphibian eggs are used.
  • the present invention is not limited to the use of any particular types of eggs. Indeed, the use of a variety of eggs is contemplated, including, but not limited to eggs from Xenopus, shrimp, sea urchin, salmon, trout or zebrafish.
  • eggs are collected from mature females and spontaneously activate upon contact with water.
  • the eggs are washed in Ringer's saline.
  • the eggs are not from an avian species.
  • Extracts of the present invention are prepared from any of the sources described in section A-D.
  • the extracts are cellular extracts.
  • Cellular extracts of the present invention are compositions of disrupted cells such as stem cells or eggs. The cells may be disrupted by a variety of methods, including, but not limited to, mechanical shearing or blending, sonication, or osmotic lysis.
  • the cellular extracts are preferably further processed to yield a composition that is substantially free of lipids naturally associated with the cells, such as cell membrane components.
  • the cellular extract comprises less than about 1%, preferably less than about 0.5%, and more preferably less than about 0.1% of lipids that are naturally associated with the cells used to make the cellular extract.
  • the extracts comprise less than about 1 % and preferably less than 0.1% cholesterol or ovalbumin.
  • the cellular extract comprises carbohydrates, proteins, glycosylated or otherwise modified proteins, peptides, amino acids, RNA (mRNA, sRNA, miRNA, rRNA), DNA, water etc, and combinations thereof.
  • the cellular extracts can comprise small amounts of lipids naturally associated with the cells, as well as nuclear components such as chromosomes, nucleic acids, and nuclear proteins.
  • the cellular extract is preferably a cytoplasmic extract prepared by removing nuclear, cell membrane and other water insoluble materials naturally associated with the cells. In some embodiments, these components are removed by centrifugation or fractionation of the disrupted cells.
  • the cellular extract is preferably an aqueous extract comprising water soluble cellular components such as proteins, mRNA, and carbohydrates. A variety of methods may be used to prepare extracts.
  • eggs are placed "dry" in a glass 15 ml centrifuge tube, and crushed by sedimentation at 15,000 g for 15 min. This produces three layers: a lipid top fraction, which is collected, aliquoted and frozen; a middle cellular fraction, which is also collected, aliquoted and frozen; and a pellet fraction, which is discarded.
  • the cellular fraction or extract primarily comprises contents of the cytoplasm.
  • the cellular fraction is used as extract.
  • the cellular fraction may be used in combination with a lipid fraction.
  • the cytoplasmic fraction may be cleared further by sedimentation at 50,000, 100,000 or 200,000 g to yield a further cellular extract which is primarily a water soluble extract fraction.
  • the extract can be diluted to about 300 mOsm with cell lysis buffer (see above), if necessary. Accordingly, in some preferred embodiment's, a water soluble extract prepared from eggs or embryos is utilized.
  • the eggs are suspended in 0.5 volume of cell lysis buffer and sonicated on ice until all eggs are lysed.
  • the particulate material is sedimented at 15,000 g for 15 min at 4°C.
  • the supernatant constitutes the extract.
  • osmolarity can be adjusted to 300 mOsm if needed.
  • the extract can also be cleared as above.
  • the eggs are suspended in cell lysis buffer as in method 2.
  • Eggs are lysed by Dounce homogenization using a glass mortar and pestle (Kontes, type A or B). The lysate is sedimented and treated as described above.
  • extracts from stem cells such as embryonic stem cells, are prepared in a like manner.
  • the stem cells are first disrupted and then centrifuged as above to remove insoluble cellular debris.
  • the stem cells generally comprise much less lipid material, so the initial centrifugation yields two main fractions, a pellet and cellular fractions which primarily contains cytoplasmic components.
  • cells are washed in ice cold PBS.
  • the cells are scraped and transferred to an ice cold centrifuge tube, such as an Eppendorf tube.
  • the cells are then pelleted and the supernatant is removed.
  • the cells are then disrupted.
  • a hypotonic solution is added to the cells in a volume of from about 1.5:1 to 3.0:1 as compared to the cell pellet.
  • a suitable hypotonic solution comprises 10 mM HEPES pH 7.9, 1.5 mM MgC12, 10 mM KCl 3.33, 0.5 mM DTT, and 0.2 mM PMSF.
  • a 10% solution of Triton X is then added (about 1/20 volume) to the pellet and the pellet resuspended by vortexing.
  • the cells are then homogenized, for example with a Dounce homogenizer or sonicated to further disrupt the cells.
  • the cellular debris is then pelleted by centrifugation, for example 6,000 RPM at 4°C for 30 seconds. The supernatant is then collected as the cellular extract.
  • the cellular extracts described above, and most preferably the middle fractions are further fractionated.
  • a variety of method may be used, including, but not limited to, FICOL gradients, gradient centrifugation, protein precipitation, freeze drying, column chromatography, such as size exclusion chromatography and affinity chromatography, gel separation, high pressure liquid chromatagraphy, ChIP 5 and immunoprecipitation. It will be recognized that these fraction steps yield corresponding fractions such as freeze dried fractions, affinity chromatography fractions, precipitated fractions, etc.
  • fractions are then combined with or resolubilized with components suitable for preparing compositions for topical administration as described in more detail below.
  • compositions of the present invention further comprise epigenetic inhibitors.
  • one or more epigenetic inhibitors are combined with one or more of the cellular extracts described in Sections A-E.
  • the present invention is not limited to the use of any particular epigenetic inhibitors. Indeed, the use of variety of epigenetic inhibitors is contemplated, including, but not limited to synthetic epigenetic inhibitors and epigenetic inhibitors isolated or derived from natural sources. Examples of epigenetic inhibitors include, but are not limited to histone deacetylase inhibitors, DNA methyltransferase inhibitors and some vitamins.
  • the epigenetic inhibitors comprises a natural extract containing butyrate or butyric acid made from natural foods such as butter from animal fats or milk (e.g. cows milk or cheese), plant oils (e.g. Heracleum giganteum (cow parsnip) and Pastinaca sativa (parsnip)), or Kombucha tea (includes Butyric Acid as a result of fermentation containing butyrate). Extract preparation may include fermentation by obligate anaerobic bacteria (e.g. Clostridium butyricum, Clostridium kluyveri, Clostridium pasteurianum, Fusobacterium nucleatum, Butyrivibrio fibrisolvens, Eubacterium limosum).
  • natural foods such as butter from animal fats or milk (e.g. cows milk or cheese), plant oils (e.g. Heracleum giganteum (cow parsnip) and Pastinaca sativa (parsnip)), or Kombucha tea (includes Butyric Acid as
  • Animal fat or plant oil product extracts may be prepared by chemical or physical processes inducing the liberation of butyric acid from the glyceride by hydrolysis.
  • the extract could also be prepared by the fermentation of sugar or starch in the natural foods by the addition of Bacillus subtilis, with calcium carbonate added to neutralize the acids formed.
  • the epigenetic inhibitors comprise a natural extract of red grapes containing the phytoalexin resveratrol, including an extract from juice or fermented juice (wine) of red grapes.
  • Extracts could be prepared by mechanical disruption of grapes, separation of the skin from the flesh and seeds, and either extracting phytoalexin by chemical or mechanical methods, or be prepared from fresh or fermented grape juice by chemical or physical methods including boiling, fractionation, affinity chromatography, freeze-drying or gel separation.
  • the epigenetic inhibitors comprise a natural extract containing Cyanocobalamin (vitamin B- 12) made from organisms containing enzymes required for the synthesis of B 12 such as bacteria and archaea, or natural products which harbor such Bl 2 producing bacteria including meat (especially liver and shellfish), eggs, and milk products. Extracts can be prepared by chemical or physical methods such as homogenization followed by fractionation, affinity chromatography, freeze-drying or gel separation.
  • the epigenetic inhibitors comprise a natural extract containing one or several variants of vitamin B, made from either potatoes, bananas, lentils, chilli peppers, tempeh, liver, turkey, tuna, nutritional yeast (or brewer's yeast), beer or marmite. Extracts can be prepared by chemical or physical methods such as homogenization followed by e.g. fractionation, affinity chromatography, freeze-drying or gel separation.
  • the epigenetic inhibitors comprise a natural extract containing retinoids or retinoid precursors, made from either animal sources (e.g. milk and eggs) which contain retinyl esters, or from plants (e.g. carrots, spinach) which contain pro-vitamin A carotenoids.
  • the extract may be modified by hydrolysis (animal sources) of retinyl esters to result in retinol, while plant extracts containing pro- vitamin A carotenoids can be cleaved to produce retinal (retinaldehyde), which can be further be reversibly reduced to produce retinol or it can be irreversibly oxidized to produce retinoic acid.
  • the best described active retinoid metabolites are 11-cis-retinal and the all-trans and 9-cis-isomers of retinoic acid, which may be added to this extract.
  • DNA methyltransferase inhibitors include, but are not limited to, 5-Azacytidine, 5-Aza-20-deoxycytidine, Arabinosyl-5-azacytidine, 5-6-Dihydro-5- azacytidine, 5-Fluoro-20-deoxycytidine, EGX30P, Epigallocatechin-3-gallate, Green tea polyphenol, Hydralazine, MG98, Procainamide, Procaine, and Zebularine.
  • histone deacetylase inhibitors include, but are not limited to Apicidin, Butyrates, Phenylbutyrate, m-Carboxycinnamic acid bishydroxamide (CBHA), Cyclic hydroxamic- acid-containing peptide 1 (CHAPl) , TSA-Trapoxin Hybrid, Depudecin Epoxide, Depsipeptide FR901228, Benzamidine, LAQ824, Oxamflatin, MGCDOl 03, PXDlOl, Pyroxamide, Suberic Bishydroxamic Acid (SBHA), Suberoylanilide Hydroxamic Acid (SAHA), Trichostatin A (TSA), Trapoxin A, Valproic acid
  • the extracts described above are formulated for topical delivery.
  • General formulations for topical delivery are described in Remington's Pharmaceutical Sciences, 18th Edition, Mack Publishing, p. 1288-1300 [1990].
  • the extracts are formulated as a water based gel or paste, ointment, cream (anhydrous or hydrous), lotion (anhydrous or hydrous), emulsion, spray, solution, aerosol, stick (solid cream), liquid band aid, powder, inhalation spray, nasal spray, basal drops, cheek drops, sublingual drops, eye drops or sprays, ear drops or sprays, and transdermal patches.
  • Other delivery methods are formulated as a water based gel or paste, ointment, cream (anhydrous or hydrous), lotion (anhydrous or hydrous), emulsion, spray, solution, aerosol, stick (solid cream), liquid band aid, powder, inhalation spray, nasal spray, basal drops, cheek drops, sublingual drops, eye drops or sprays, ear drops or sprays, and transdermal
  • the extracts described above are formulated for delivery by a variety of methods.
  • the extracts described above are formulated for delivery to skin, gastrointestinal tractus, fat deposits, cartilage, bone, connective tissue, muscle or internal organs.
  • the extracts or components thereof are formulated for oral administration with or without suitable carriers such as starch, sucrose or lactose in tablets, pills, dragees, capsules, solutions, liquids, slurries, suspensions and emulsions.
  • the oral delivery vehicle comprises an enteric coating.
  • the extracts or components thereof are formulated for rectal administration as a capsule, cream, suppository or liquid.
  • the extracts of components thereof are injected by syringe to the peritoneal cavity or into internal organs or tissues, hi some embodiments, the extracts or components thereof are formulated for delivery an osmotic pump. In still other embodiments, the extracts or components thereof are delivered by microinjection, preferably via particle bombardment ⁇ i.e., with a gene gun). Particle mediated gene transfer methods are known in the art, are commercially available, and include, but are not limited to, the gas driven gene delivery instrument descried in McCabe, U.S. Pat. No. 5,584,807, the entire contents of which are herein incorporated by reference.
  • This method involves coating the nucleic acid sequence of interest onto heavy metal particles, and accelerating the coated particles under the pressure of compressed gas for delivery to the target tissue.
  • Other particle bombardment methods are also available. Generally, these methods involve depositing the extract or components thereof upon the surface of small, dense particles of a material such as gold, platinum, or tungsten. The coated particles are themselves then coated onto either a rigid surface, such as a metal plate, or onto a carrier sheet made of a fragile material such as mylar. The coated sheet is then accelerated toward the target biological tissue. The use of the flat sheet generates a uniform spread of accelerated particles that maximizes the number of cells receiving particles under uniform conditions, resulting in the introduction of the nucleic acid sample into the target tissue.
  • the embryonic stem cell, adult stem cell or egg extracts or components are microencapsulated (e.g., with collagen or glycosaminoglycans), formed into nanoparticles (e.g., lecithin encapsulated in an oil core), liposomes, microemulsions, or nanoemulsions, oil bodies, retinol molecular fluid films, unilamellar vesicles, multilamellar vesicles, preloaded spherical beads or sponges, elastic vesicles, etc.
  • the composition for topical and/or internal, application is a combination of extracts with lipids and/or water and/or carbohydrates and/or nucleic acids and/or proteins and/or signaling substances.
  • the extract herein is composed of whole cells or a combination of lipids and/or carbohydrates and/or nucleic acids and/or proteins and/or signaling substances of the cells from which the extract is made, or from synthetic and/or natural versions of lipids and/or carbohydrates and/or nucleic acids and/or proteins and/or signaling substances.
  • Signaling profiles include combinations of active substances released from cells which are contained in extracts of cells, and include synthetic and/or natural versions of these signaling substances added to extracts.
  • Signaling substances contemplated include but are not limited to growth factors, endorphins, hormones, amino acid transmitters, immunoregulatory cytokines and other immunity-associated factors.
  • TGF- B5 Transforming growth factor- ⁇ 5
  • a member of this signaling factor family found in amphibians is expressed in regenerating blastemas formed under limb regeneration (King et al., 2003), and all mammalian isoforms of TGF- ⁇ are released locally from various cells at sites of injury and are important in the control of fibrosis and scarring during mammalian tissue repair.
  • Manipulation of specific TGF- ⁇ isoforms is capable of producing scar-free healing of wounds in mice (Ferguson and O'Kane, 2004).
  • TGF- ⁇ l is a potent immunoregulatory cytokine involved in suppression of inflammation and regulatory T cell activity, resulting in immune tolerance (Chen and Wahl, 2003). Studies on wound healing and immunosuppression in mammals indicates that differential activity of TGF- ⁇ in regenerating amphibian limb stumps may be involved suppression of fibrosis and establishing conditions permissive for blastema formation.
  • TGF-alpha Transforming growth factor-alpha
  • BDNF brain-derived neurotrophic factor
  • TGF-alpha Transforming growth factor-alpha
  • BDNF brain-derived neurotrophic factor
  • Fibroblast growth factors such as FGF- 10 have been demonstrated to be of importance in regrowth of limbs in frogs (Christen and Slack, 1997; Yokoyama et al., 2000).
  • POMC Pro-opiomelanocortin
  • ⁇ -MSH a-melanocyte stimulating hormone
  • endorphins endorphins
  • several other peptide hormones is expressed in regeneration blastemas (King et al., 2003), in skin as well as brain, pituitary, and other organs.
  • POMC is a central importance in modulating immune activity within skin, primarily due to the activity of ⁇ -MSH (Luger et al., 1999). Paracrine release of ⁇ -MSH peptides exerts a potent immunomodulatory effect on immune cells.
  • ⁇ -MSH inhibits all forms of inflammation against which it has been tested (Lipton et al., 1997) and localized production of ⁇ -MSH helps maintain optimal immune response at specific sites in the skin (Paus et al., 2003). Expression of ⁇ -MSH cells of a blastema would be expected to confer an anti-inflammatory effect potentially important for inhibiting fibrosis and regeneration necessary for limb or tissue regrowth.
  • Thymosin- ⁇ 4 is a thymic maturation factor that has also been shown to promote angiogenesis, keratinocyte migration and wound healing (Malinda et al., 1999). thymosin- ⁇ 4 exerts potent anti-inflammatory activity and is secreted by macrophages and T lymphocytes of skin, gut and other organs in addition to the thymus (Young et al., 1999; Girardi et al., 2003).
  • Thymosin-U4 is up-regulated in frog pseudoblastemas (King et al., 2003) and regenerating blastemas and activities of thymosin-B4 in tissues of amputated limbs may include immunomodulation of the inflammatory response in addition to stimulation of epithelial migration and other aspects of regeneration.
  • extracts or components thereof described above are combined with additional components.
  • these additional components enhance uptake, bioavailability or penetration of the extract components.
  • extract components may contain natural or a mixture of synthetic components.
  • the components may be partially or totally synthetic.
  • the cell or extract or synthetic components made from substances identified in the extracts are mixed with a composition comprising water, sebaceous and epidermal lipids and cell extracts, proteins, and components thereof, preferably comprises about a 10% lipid fraction by weight, about a 10% protein fraction by weight, and about an 80% volatile fraction by weight.
  • Vernix Vemix caseosa (vernix) is a naturally occurring skin protectant. Vernix is a lipid rich substance composed of sebum, epidermal lipids, and desquamated epithelial cells that progressively covers the skin of the developing fetus, completely surrounded by amniotic fluid, during the last trimester of pregnancy.
  • the invention relates to compositions where the lipid fraction preferably comprises components in vernix, i.e., lecithin and other phospholipids, squalene, waxes, wax esters, sterol esters, diol esters, triglycerides, free sterols and four classes of fatty acids ranging in chain length from C 12 to C 26 (straight chain saturated, straight chain unsaturated, branched chain saturated, and branched chain unsaturated).
  • vernix i.e., lecithin and other phospholipids, squalene, waxes, wax esters, sterol esters, diol esters, triglycerides, free sterols and four classes of fatty acids ranging in chain length from C 12 to C 26 (straight chain saturated, straight chain unsaturated, branched chain saturated, and branched chain unsaturated).
  • the vernix lipid components are as follow, with the relative percentages indicated, squalene (9%), aliphatic waxes (12%), sterol esters (33%), diesters (7%), triglycerides (26%), free sterols (9%), other lipids (4%).
  • the lipid composition is composed of lipids from egg and/or fish roe with wound healing properties 30% of which are barrier lipids (proteolipid matrix); cholesterol (1.1 %, 52.8 % of barrier), free fatty acids (0.6%, 27.7% of barrier), phospholipids (0.4%), ceramides (0.7 %, 20.1 % barrier).
  • the protein fraction contains the protein components of vemix, i.e., keratin, filaggrin, regulator proteins (e.g. EGF), and glutamine.
  • the fatty acids within the aliphatic waxes may be branched and the branched fatty acids may be methylated.
  • the protein fraction consists of epidermally derived proteins, primarily keratin and filaggrin.
  • the protein fraction also contains trace amounts in the range of about micromolar to millimolar concentrations of regulatory proteins such as epidermal growth factor (EGF), and trace amounts of about nanomolar to micromolar concentrations of surfactant protein such as Surfactant A and Surfactant B.
  • the volatile fraction is primarily water. The rate of evaporation of volatile components is relatively slow, presumably due to increased energy requirements for the dissociation of hydrogen bonds and for diffusion from the cellular component through the lipid component to change water from the liquid to the gaseous state.
  • the composition contains mRNA contained in cell extracts, preferably stem cell extracts.
  • the embryonic stem cell, adult stem cell or egg extracts or components are combined with phospholipids or other lipophilic substances, palmitylmyristrates, dimethylsulfoxide (DMSO), chitosan, long chain organic polymers such as polysaccharides, non-aqueous solvents, beta-glucan, pH adjusting components, skin metabolism inhibition agents, propylene glycol, butylenes glycol, polyethylene glycol, olive oil or other naturally occurring oils, dimethyl isosorbide, dimethylformamide, methyl salicylate, long chain oleic acid, mucopolysaccharides, and other agents.
  • DMSO dimethylsulfoxide
  • the additional agents include, but are not limited to, ubiquitin, antimicrobial agents (alpha-defensins, LL37, beta-defensins, etc.), surfactant proteins from the collectin family (collecting associated protein A and D), nicotinamide and psoriacin.
  • the additional agents include, but are not limited to, vitamins, antioxidants, minerals, extracts, and chemical compounds such as alpha-tocopherol (vitamin E), melanin, vitamin C, provitamin A, retinyl proprionate, retinoic acid, Vitamin D3, Nicotinamide (vitamin B), Niacinaminde (Vit B3, exfoliates surface skin), d-panthenol (aids in skin repair of damage), vitamin A, hyaluronic acid, ceramides, Seaweed (algae) Mineral oil (paraffinum liquidium) Petrolatum Glycerin Isohexadecane Cirrus aurantifolia (lime) extract Microcrystalline wax (cera microcristallina) Lanolin alcohol Seamum indicium (sesame) seed oil, Eucalyptus globules (eucalyptus) leaf oil, Magnesium sulfate, Sesamum indicum (sesame) seeds, Medica
  • vitamin E
  • compositions for topical application described above find use for both cosmetic and therapeutic purposes. Therapeutic uses are described in more detail in Section J.
  • the compositions described above are applied directly to the skin or other epithelial or epidermal surfaces of the body.
  • the compositions may be applied one, two, three or more times each day as is appropriate for the indication.
  • the amount applied is not generally important, but generally a composition comprising from about 0.001 ⁇ g to 10 grams of the extract (or components thereof) may be applied to a given surface of the body.
  • the composition may comprise other components such as adjuvants, carriers, other active ingredients, etc.
  • the invention relates to compositions that include preservatives and antioxidants (including vitamins) to prevent product deterioration preferably trisodium and tetrasodium edetate (EDTA) and tocopherol (vitamin E).
  • the composition contains antimicrobials to fight bacteria preferably butyl, propyl, ethyl, and methyl parabens, DMDM hydantoin, methylisothiazolinone phenoxyethanol (also rose ether fragrance component), quaternium-15.
  • the composition contains thickeners and waxes used in stick products such as lipsticks and blushers preferably candelilla, carnauba, and microcrystalline waxes carbomer and polyethylene — thickeners.
  • the composition contains solvents to dilute preferably butylene glycol and propylene glycol, cyclomethicone (volatile silicone), ethanol (alcohol) and glycerin.
  • the composition contains emulsiflers to break up and refine preferably glyceryl monostearate (also pearlescent agent), lauramide DEA (also foam booster) and polysorbates.
  • the compositions contain color additives—synthetic organic colors derived from coal and petroleum sources preferably D&C Red No. 7 Calcium Lake (and other dyes that do not dissolve in water), iron oxides, mica (iridescent), and aminophenols.
  • the compositions contain pH adjusters to stabilize or adjust acids and bases preferably ammonium hydroxide— in skin peels and hair waving and straightening, citric acid— adjusts pH, and triethanolamine--pH adjuster used mostly in transparent soap.
  • compositions contains agents preferably magnesium aluminum silicate— absorbent, anti-caking agent, silica (silicon dioxide)— absorbent, anti-caking, abrasive, sodium lauryl sulfate — detergent, stearic acid— cleansing, emulsifier, talc (powdered magnesium silicate) ⁇ absorbent, anti-caking, and zinc stearate— used in powder to improve texture, lubricates.
  • agents preferably magnesium aluminum silicate— absorbent, anti-caking agent, silica (silicon dioxide)— absorbent, anti-caking, abrasive, sodium lauryl sulfate — detergent, stearic acid— cleansing, emulsifier, talc (powdered magnesium silicate) ⁇ absorbent, anti-caking, and zinc stearate— used in powder to improve texture, lubricates.
  • the composition includes the recited components and combinations thereof in a total amount of about 0.5 to 50 grams per liter, preferably about 3 to 10 grams per liter, although higher or lower concentrations are permissible.
  • Such compositions being in the form of an • emulsion, cream, salve or the like, the active materials being admixed with water, alkylene glycols, various oils natural and synthetic, petrolatum, preservatives, coloring agents, perfumes, and like ingredients conventional in the cosmetic arts.
  • the composition can be applied to the face, eyelids or other body parts in an amount varying with the individual. About 0.01 to 1, advantageously about 0.02 to 0.75 and preferably about 0.3 to 0.5, grams per cm 2 has been found useful but more or less can be used.
  • the application can be once weekly or more often, even several times a day.
  • the egg, embryo or stem cell extracts of the present invention may be administered in the form of a pharmaceutical composition additionally comprising a pharmaceutically acceptable carrier.
  • a pharmaceutically acceptable carrier are also well known to those skilled in the art. The choice of carrier will be determined, in part, both by the particular composition and by the particular method used to administer the composition. Accordingly, there is a wide variety of suitable formulations of the pharmaceutical compositions of the present invention.
  • the formulations of this invention are designed for topical administration.
  • Typical of such formulations are ointments, creams, and gels.
  • Ointments generally are prepared using either (1) an oleaginous base, i.e., one consisting of fixed oils or hydrocarbons, such as white petrolatum or mineral oil, or (2) an absorbant base, i.e., one consisting of an anhydrous substance or substances which can absorb water, for example, anhydrous lanolin.
  • an oleaginous base i.e., one consisting of fixed oils or hydrocarbons, such as white petrolatum or mineral oil
  • an absorbant base i.e., one consisting of an anhydrous substance or substances which can absorb water, for example, anhydrous lanolin.
  • the active ingredient e.g., salmon egg extract or stem cell extract
  • Creams are oil/water emulsions.
  • an oil phase comprising typically fixed oils, hydrocarbons, and the like, such as waxes, petrolatum, mineral oil, and the like
  • an aqueous phase continuous phase
  • the two phases are stabilized by use of an emulsifying agent, for example, a surface active agent, such as sodium lauryl sulfate; hydrophilic colloids, such as acacia colloidal clays, veegum, and the like.
  • an active ingredient e.g., salmon egg extract or stem cell extract
  • customarily is added in an amount to achieve the desired concentration.
  • Gels comprise a base selected from an oleaginous base, water, or an emulsion- suspension base, such as aforedescribed.
  • a gelling agent which forms a matrix in the base, increasing its viscosity.
  • gelling agents are hydroxypropyl cellulose, acrylic acid polymers, and the like.
  • the active ingredient is added to the formulation at the desired concentration at a point preceding addition of the gelling agent.
  • the amount of extract incorporated into the formulation of this invention is not critical; the concentration should only be in a range sufficient to permit ready application of the formulation to the wound area in an amount which will deliver the desired amount of extract.
  • the customary amount of formulation to be applied will depend upon concentration of the active ingredient in the formulation.
  • the amount of protein in the extract is determined.
  • a specific amount of the extract is included in the pharmaceutically acceptable carrier based on the amount of protein.
  • the formulation will be applied to the wound in an amount affording from about 0.1 to about 500 ⁇ g of protein per cm 2 of skin.
  • the applied amount of protein will range from about 1 to about 300 ⁇ g/cm 2 , more preferably, from about 5 to about 200 ⁇ g/cm 2 .
  • compositions of the present invention comprise on a volume/volume basis (volume of extract and volume of pharmaceutically acceptable carrier), for example, from about 0.001 to 50% extract, about 0.01 to 50% extract, about 0.1 to 50% extract, about 0.001 to 10% extract, about 0.01 to 10% extract, about 0.1 to 10% extract, about 0.001 to 5% extract, about 0.01 to 5% extract, about 0.1 to 5% extract, about 0.001 to 4% extract, about 0.01 to 4% extract, about 0.1 to 4% extract, about 0.001 to 2% extract, about 0.01 to 2% extract, about 0.1 to 2% extract, about 0.001 to 1% extract, about 0.01 to 1% extract, or about 0.1 to 1% extract.
  • a volume/volume basis volume of extract and volume of pharmaceutically acceptable carrier
  • the present invention may be formulated as necessary with additives used commonly in the pharmaceutical sciences, such as surfactants, oils and fats, polyhydric alcohols, lower alcohols, thickening agents, UV absorbents, light scattering agents, preservatives, antioxidants, antibiotics, chelating agents, pH regulators, flavoring agents, pigments and water.
  • additives used commonly in the pharmaceutical sciences such as surfactants, oils and fats, polyhydric alcohols, lower alcohols, thickening agents, UV absorbents, light scattering agents, preservatives, antioxidants, antibiotics, chelating agents, pH regulators, flavoring agents, pigments and water.
  • surfactants include polyoxyethylene (hereinafter abbreviated as POE- branched alkyl ethers such as POE-octyldodecyl alcohol and POE-2-decyltetradecyl alcohol, POE-alkyl ethers such as POE-oleyl alcohol ether and POE-cetyl alcohol ether, sorbitan esters such as sorbitan monooleate, sorbitan monoisostearate and sorbitan monolaurate, POE-sorbitan esters such as POE-sorbitan monooleate, POE-sorbitan monoisostearate and POE-sorbitan monolaurate, fatty acid esters of glycerol such as glyceryl monooleate, glyceryl monostearate and glyceryl monomyristate, POE-fatty acid esters of glycerol such as POE-glyceryl monooleate, POE-glyceryl monosteate
  • oils and fats include vegetable oils and fats such as castor-oil, olive oil, cacao oil, camellia oil, coconut oil, wood wax, jojoba oil, grape seed oil and avocado oil; animal oils and fats such as mink oil and egg yolk oil; waxes such as beeswax, whale wax, lanolin, carnauba wax and candelilla wax; hydrocarbons such as liquid paraffin, squalene, microcrystalline wax, ceresine wax, paraffin wax and vaseline; natural or synthetic fatty acids such as lauric acid, myristic acid, stearic acid, oleic acid, isostearic acid and behenic acid; natural or higher alcohols such as cetanol, stearyl alcohol, hexyldecanol, octyldecanol and lauryl alcohol; and esters such as isopropyl myristate, isopropyl palmitate, octyldodecyl myristate, o
  • polyhydric alcohols examples include ethylene glycol, polyethylene glycol, propylene glycol, 1,3-butyrene glycol, 1,4-butyrene glycol, dipropylene glycol, glycerol, diglycerol, triglycerol, tetraglycerol and other polyglycerols, glucose, maltose, maltitose, sucrose, fructose, xylitose, sorbitol, maltotriose, threitol and erythritol.
  • thickening agents include naturally-occurring high molecular substances such as sodium alginate, xanthene gum, aluminum silicate, quince seed extract, gum tragacanth, starch, collagen and sodium hyaluronate; semi-synthetic high molecular substances such as methyl cellulose, hydroxyethyl cellulose, carboxymethyl cellulose, soluble starch and cationized cellulose; and synthetic high molecular substances such as carboxyvinyl polymer and polyvinyl alcohol.
  • high molecular substances such as sodium alginate, xanthene gum, aluminum silicate, quince seed extract, gum tragacanth, starch, collagen and sodium hyaluronate
  • semi-synthetic high molecular substances such as methyl cellulose, hydroxyethyl cellulose, carboxymethyl cellulose, soluble starch and cationized cellulose
  • synthetic high molecular substances such as carboxyvinyl polymer and polyvinyl alcohol.
  • UV absorbents include p-aminobenzoic acid, 2-ethoxyethyl p- methoxycinnamate, isopropyl p-methoxycinnamate, butylmethoxybenzoylmethane, glyceryl-mono-2-ethylhexanoyl-di-p-methoxybenzophenone, digalloyl trioleate, 2,2'- dihydroxy-4-methoxybenzophenone, ethyl-4-bishydroxypropylaminobenzoate, 2- ethylhexyl-2-cyano-3,3'-diphenyl acrylate, ethylhexyl p-methoxycinnamate, 2-ethylhexyl salicylate, glyceryl p-aminobenzoate, homomethyl salicylate, methyl o-aminobenzoate, 2- hydroxy-4-methoxybenzophenone, amyl p-
  • preservatives examples include benzoates, salicylates, sorbates, dehydroacetates, p-oxybenzoates, 2,4,4'-trichloro-2'-hydroxydiphenyl ether, 3,4,4'-trichlorocarbanilide, benzalkonium chloride, hinokitiol, resorcinol and ethanol.
  • antioxidants examples include tocopherol, ascorbic acid, butylhydroxyanisole, dibutylhydroxytoluene, nordihydroguaiaretic acid and propyl gallate.
  • chelating agents examples include sodium edetate and sodium citrate.
  • antibiotics examples include penicillin, neomycin, cephalothin, potassium permanganate, selenium sulfide, erythromycin, bacitracin, tethacyclin, chloramphenicol, vancomycin, nitrofurantoin, acrisorcin, chlorodontoin, and flucytosine.
  • any dosage form is acceptable, whether in solution, emulsion, powder dispersion, or others. Applicability is wide, including fundamental dosage forms such as lotions, emulsions, creams and gels.
  • suitable vehicles, carriers and adjuvants include water, vaseline, petrolatum, mineral oil, vegetable oil, animal oil, organic and inorganic waxes, polymers such as xanthanes, gelatin, cellulose, collagen, starch, kaolin, carrageenan, gum arabic, synthetic polymers, alcohols, polyols, and the like.
  • the carrier can also include sustained release carrier such as lypizomes, microsponges, microspheres, or microcapsules, aqueous base ointments, water in oil or oil in water emulsions, gels or the like.
  • the dose administered to an animal, particularly a human, in the context of the present invention should be sufficient to effect a therapeutic response over a reasonable time frame.
  • the dose will be determined by the strength of the particular compositions employed and the condition of the person.
  • the size of the dose and the frequency of application also will be determined by the existence, nature, and extent of any adverse side effects that may accompany the administration of a particular composition. L. Therapeutic uses
  • the cell or extract compositions are useful for hydration (i.e., treating intravascular dehydration and edema in a wounds), waterproofing (i.e., compensate for hypovolemia in wounds), guarding against infection (i.e., protecting wound against infections), protection against oxidation (i.e., prevention of oxygen-free radical production during inflammatory reactions of ischemic tissue), wound healing (i.e., increased metabolism to aid in hypoxic conditions especially of burned skin or cells in anaerobic metabolism).
  • the compositions are odorless (i.e., characterized by an absence of volatile carbon or nitrogen containing compounds).
  • the invention relates to methods of using a plurality of compositions.
  • a first cream is used to loosen and/or dissolve cars by collagen dissolving agents or acids.
  • a laser, chemical peel, razor, acid, freezing, exfoliant and/or abrasive is used to remove scars or wrinkles followed by application of a cream with extracts or components thereof as well as other wound healing substances as described herein.
  • the invention relates to a first composition preferably a cream that slows wound healing, reduces inflammation, and/or reduces scab formation.
  • This composition is applied for several days.
  • the composition comprises a combination of one or more of anti-inflammatory agents, antihistamines, an extract component or components capable of dampening neutrophil migration and/or proliferation, an extract component or components the stimulate macrophages, phospholipases, arachidonic acid.
  • the components in the composition reduce activity of fibrogen cytokines.
  • the first composition is applied for about 1 to 3 days.
  • the invention relates to a second composition preferably a cream that heals wounds by stimulating needed cells.
  • this composition is applied to a subject after the first composition is applied.
  • the second composition is applied for about 3 to 14 days.
  • This second composition contains components of cell and cell extracts that regulate collagenases, activate plasminogenases for clot dissolution, stimulate epithelializaiton, (i.e., migration, proliferation, dedifferentiation, redifferentiation), activate fibronectin and fibroblast growth factors, stimulate angiogenesis, reduce activity of fibrogenic cytokines and regulate genes such as TP53.
  • the invention relates to a third composition preferably a cream.
  • this composition is applied to a subject after the application of the second composition.
  • This third composition functions to control collagen remodeling by collagen synthesis and destruction preferably by collegenases and metalloproteins and preferably collagan I and inactivate fibronectin, hyaluroinic acid and glycosaminoglycans, and dehydrate swelling.
  • the third composition is preferably applied for about one to six weeks, following the application of the firs and second compositions.
  • a matrix is provided, such as a chitosan matrix, biodegradable polymer matrix, collagen matrix, or liquid band aid.
  • the cell and/or extract composition is dispersed in a biocompatible liquid was applied to a physiologically acceptable support structure in a liquid state to form a film.
  • a film is defined herein as a surface and/or interfacial covering, in either a liquid or a solid state, with temperature-dependant properties. Film- forming techniques include but are not limited to spraying, extruding, blowing, pouring, evaporating, coating and painting. The dispersion is presented as droplets that coalesce to form a film upon encountering the support.
  • a preformed film is applied to a support.
  • the physiologically acceptable support structure is one that can withstand sterilization, preferably by standard sterilization techniques known to one skilled in the art such as exposure to gamma radiation, autoclaving, and so on.
  • the support structure is not limited to a particular composition or configuration and, depending upon its use, may or may not be sterilized and may take various forms.
  • the film is used to enhance skin cell maturation and may be applied to structures such as filters, membranes, beads, particles, and so on.
  • the support structure is not limited to a particular state of matter and may be a solid, a semisolid, a gel and so on.
  • the support consists of a nylon monofilament interpositional surfacing material such as Interfaces pads (Winfield Laboratories, Inc., Dallas Tex.), Biobrane II.RTM. (Sterling Drug Inc., New York, N. Y.) or circular nylon filters of suitable porosity (Micron Separations Inc., Westboro, Mass.).
  • a nylon monofilament interpositional surfacing material such as Interfaces pads (Winfield Laboratories, Inc., Dallas Tex.), Biobrane II.RTM. (Sterling Drug Inc., New York, N. Y.) or circular nylon filters of suitable porosity (Micron Separations Inc., Westboro, Mass.).
  • Other support materials could also be used to practice the invention.
  • the film is used to treat or prevent injury due to substance exposure or trauma, and may be applied to various materials for placement either in direct contact or indirect contact with an exposed skin site.
  • the skin site may be intact (e.g., normal skin) or may be compromised, defined as skin that is damaged or that lacks at least some of the stratum corneum (e.g., skin damaged by exposure to the agent in question, another agent, the presence of a pathological condition such as a rash or contact dermatitis, a physical trauma such as a cut, wound, or abrasion, a underdeveloped skin such as occurs in a preterm infant, conditions in which either all or part of the epidermis is exposed, conditions in which part of the dermis has been removed such as partial thickness wounds encountered in resurfacing procedures such as chemical peels, dermabrasions, and laser resurfacing, etc.).
  • stratum corneum e.g., skin damaged by exposure to the agent in question, another agent, the presence of a pathological condition such as a rash or contact dermatitis, a physical trauma such as a cut, wound, or abrasion, a underdeveloped skin such as occurs in a preterm infant,
  • the support structure may be permeable to physical and/or chemical agents, and may take a variety of forms, depending upon its purpose and the extent of the area requiring dressing or treatment.
  • the film may be applied to various synthetics such as thermoplastic films, blown films and breathable films, and various natural and synthetic fabric compositions such as woven, non- woven, spun, and stitched fabrics.
  • the invention may be used in a variety of products, examples of which include wound dressings and coverings such as bandages, tapes, gauze, adhesive products applied for a short or long term to the skin, ostomy care products, hospital pads such as incontinent pads, absorbent pads, and examination pads, disposable and cloth diapers, and feminine hygiene products such as intralabial devices.
  • the invention relates to regeneration of the function of skin with a desired cosmetic appearance and the prevention of skin damage.
  • early scar formation is prevented by application of a scar prevention composition when the wound is formed.
  • stimulating the rejuvenation and regeneration of stressed and aging skin prevents wrinkle formation.
  • the product is applied intermittently to slow the continual damage process that occurs as skin ages.
  • the skin has two main layers, the epidermis and dermis. Below these is a layer of subcutaneous ('under the skin') fat.
  • the outer surface of the skin is the epidermis, which itself contains several layers — the basal cell layer, the spinous layer, the granular cell layer, and the stratum corneum.
  • the deepest layer of the epidermis is the basal cell layer.
  • cells are continually dividing to produce plump new skin cells. These cells move towards the skin surface, pushed upward by the dividing cells below them.
  • Blood vessels in the dermis which is below the basal cell layer — supply nutrients to support this active growth of new skin cells.
  • As the basal cells move upwards and away from their blood supply their cell content and shape change. Cells above the basal cell layer become more irregular in shape and form the spinous layer. Above this, cells move into the granular layer. Being distant from the blood supply in the dermis, the cells begin to die and accumulate a substance called keratin.
  • the stratum corneum ('horny layer') is the top layer of the epidermis — it is the layer of the skin that we see from the outside.
  • Cells here are flat and scale-like ('squamous') in shape. These cells are dead, contain a lot of keratin and are arranged in overlapping layers that impart a tough and waterproof character to the skin's surface. Dead skin cells are continually shed from the skin's surface. This is balanced by the dividing cells in the basal cell layer, thereby producing a state of constant renewal.
  • Also in the basal cell layer are cells that produce melanin. Melanin is a pigment that is absorbed into the dividing skin cells to help protect them against damage from sunlight (ultraviolet light). The amount of melanin in your skin is determined by genetic makeup and one's exposure to sunlight. The more melanin pigment present, the darker the color of your skin.
  • the dermis below the epidermis is the layer called the dermis.
  • the top layer of the dermis the one directly below the epidermis — has many ridges called papillae.
  • the dermis contains a variable amount of fat, and also collagen and elastin fibres that provide strength and flexibility to the skin. In an older person the elastin fibres fragment and much of the skin's elastic quality is lost. This, along with the loss of subcutaneous fat, results in wrinkles.
  • Blood vessels supply nutrients to the dividing cells in the basal layer and remove any waste products. They also help maintain body temperature by dilating and carrying more blood when the body needs to lose heat from its surface; they narrow and carry less blood when the body needs to limit the amount of heat lost at its surface.
  • the skin also contains a number of nerves and glands.
  • the dermis also becomes thin, with a decrease in elastic fibers, collagen production, vascularity, and ground substance.
  • the biochemical alterations in collagen and elastin result in a dermis that is more lax yet less elastic and resilient. Collectively, these changes result in fine wrinkling of the skin and sagging of the tissues that overlay the facial skeleton.
  • the invention relates to composition comprising extracts that can stimulate skin cells to regenerate spontaneously.
  • cells with elongated telomeres made in situ from the subject's own cells are reintroduced to the subject.
  • Modalities can resurface the skin to improve skin quality, reduce age spots, soften fine lines, and treat acne or other scars.
  • Modalities include traditional dermabrasion, chemical peeling, laser resurfacing, and microdermabrasion.
  • the techniques attempt to remove the outer layers of skin with the idea that stimulating new growth will improve appearance.
  • the initial evaluation of skin condition is typically accomplished using Fitzpatrick's scale of sun-reactive skin types, which denotes patients' reactions to ultraviolet radiation and existing degree of pigmentation.
  • Type I patients always burn and never tan.
  • Type II patients tan only with difficulty and usually burn.
  • Type III patients tan but sometimes burn.
  • Type IV patients rarely burn and tan with ease.
  • Type V patients tan very easily and very rarely burn.
  • Type VI patients tan very easily and never burn.
  • Chemical peeling is the chemical removal of layers of skin to improve dermatologic defects.
  • the mechanism of action of peeling agents is relatively straightforward. Stronger agents such as phenol (with various additives such as croton oil and glycerin) and trichloroacetic acid (TCA) produce a chemical necrosis of the skin to variable depths, depending on a number of controlled and uncontrolled variables.
  • the weaker agents change the pH sufficiently to cause a superficial shock to the cells and, depending on many variables, cell injury or death.
  • the acid acts simply to cause cellular and intercellular swelling and plumping, leading to transient increase in cell and matrix size and lessening of fine lines and rhytides. Sequential treatments lead to exfoliation and a smoother complexion.
  • the phenol peel "The Baker formula” is phenol USP 88% 3 cm 3 49%; distilled xvater 2 cm 3 44%; croton oil 3 drops 2.1%; and Septisol 8 drops 4.5%.
  • microdermabrasion abrades the skin with a high-pressure flow of crystals.
  • Microdermabrasion is most effective with superficial skin conditions because it produces a superficial depth of injury.
  • Superficial skin conditions include early photoaging, fine lines, and superficial scarring.
  • Microdermabrasion is accomplished by placing the skin under tension so that an effective vacuum is achieved. Typically, stretching the treatment area with the nondominant hand and using the dominant hand to guide the handpiece is the method used to achieve this effect.
  • the neck is placed in extension to assist in skin tension.
  • the handpiece is moved over the treatment area in a single, smooth stroke, which can then be repeated.
  • the pressure of the crystal stream is controlled with a foot pedal.
  • Thicker skin such as that on the forehead, chin, and nose, can be treated more aggressively (ie, adjust the speed of handpiece movement or number of passes). Decrease the pressure when treating the thinner skin of the lower eyelids and upper cheek. Vertically orient all strokes when treating the neck.
  • Laser skin resurfacing can be performed as an isolated procedure or as an adjunct to procedures such as transconjunctival blepharoplasty (TCB), facelift, and endoscopic browlift.
  • TB transconjunctival blepharoplasty
  • the laser allows for precise control of ablation depth, and it permits the surgeon to vary these depths as needed.
  • LSR causes favorable heating of the dermis, which tightens collagen fibers and stimulates neocollagen secretion by fibroblasts.
  • Two laser wavelengths are preferred for facial skin resurfacing: pulsed carbon dioxide and erbium:yttrium-aluminum-garnet (Er: YA G).
  • the composition of the present invention also finds use in wound healing.
  • a wound is a break in the skin (the outer layer of skin is called the epidermis). Wounds are usually caused by cuts or scrapes. Healing is a response to the injury that sets into motion a sequence of events. With the exception of bone, all tissues heal with some scarring. The object of proper care is to minimize the possibility of infection and scarring.
  • Pressure ulcers are chronic wounds caused by unrelieved pressure that results in tissue damage.
  • the ulcers are staged from I to IV, according to the level of tissue damage observed.
  • Pressure ulcers are most common in hospitalized patients, nursing home patients and those with spinal cord injuries.
  • the standard of care for pressure ulcers includes interval dressing changes, pressure relief, repositioning, physical strengthening, nutritional support and infection management. If the wound becomes severe, surgical interventions include wound debridement and skin-flap, muscle-flap or free-flap reconstruction.
  • the present invention also finds use for the treatment of various skin disorders.
  • Callus formation is a thickening of the skin due to intermittent pressure and frictional forces.
  • the shape of the hands and feet are important in clavus formation. Specifically, the bony prominences of the metacarpophalangeal and metatarsophalangeal joints often are shaped in such a way as to induce overlying skin friction. As clavus formation ensues, friction against the footwear is likely to perpetuate hyperkeratosis. Toe deformity, including contractures and claw, hammer, and mallet-shaped toes, may contribute to pathogenesis.
  • Bunionettes ie, callosities over the lateral fifth metatarsal head
  • Morton toe in which the second toe is longer than the first toe, occurs in 25% of the population; this may be one of the most important pathogenic factors in a callus of the common second metatarsal head, ie, an intractable plantar keratosis.
  • Moles are nests of melanocytes that are in contact with each other. They typically start formation during early childhood. It has been suggested that they form in response to sun exposure. However, a genetic factor is clearly involved in nevi. Some kinships express an autosomal dominant condition in which members have a large number of large nevi, sometimes more than 150 nevi scattered over the integument. Nevi have been observed to develop rapidly after blistering events, such as second-degree thermal burns or sunburns; toxic epidermal necrolysis; and in persons with genetic blistering diseases, such as epidermolysis bullosa. Growth factors, such as basic fibroblast growth factor, have been suggested to be released by proliferation keratinocytes and to stimulate melanocyte proliferation.
  • Melanocyte nevi are benign neoplasms or hamartomas composed of mostly melanocytes, the pigment-producing cells that colonize the epidermis. Melanocytes are derived from the neural crest and migrate during embryologic development to selected ectodermal sites (primarily the skin and the CNS) but also to the eyes and the ears. Ectopic melanocytes have been identified at autopsy in the gastrointestinal and genitourinary tracts. Congenital melanocyte nevi are thought to represent an anomaly in embryogenesis and as such could be considered a malformation or a hamartoma. In contrast, most acquired melanocyte nevi are considered to be benign neoplastic proliferations.
  • Atypical moles/dysplastic nevi are acquired melanocyte lesions of the skin whose clinical and histologic definitions are still evolving. Atypical moles differ from common acquired melanocyte nevi in several respects, including diameter and lack of pigment uniformity
  • Cipillary hemangiomas are one of the most common benign orbital tumors of infancy. They are benign endothelial cell neoplasms that are typically absent at birth and characteristically have rapid growth in infancy with spontaneous involution later in life. This is in contrast to another known group of childhood vascular anomalies, vascular malformations. vascular malformations, such as lymphangiomas and arteriovenous malformations, are present at birth and are characterized by very slow growth with persistence into adult life.
  • Striae distensae affect skin that is subjected to continuous and progressive stretching; increased stress is placed on the connective tissue due to increased size of the various parts of the body. It occurs on the abdomen and the breasts of pregnant women, on the shoulders of body builders, in adolescents undergoing their growth spurt, and in individuals who are overweight. Skin distension apparently leads to excessive mast cell degranulation with subsequent damage of collagen and elastin. Prolonged use of oral or topical corticosteroids or Cushing syndrome (increased adrenal cortical activity) leads to the development of striae.
  • Acne manifestation is defined by the distribution of the pilosebaceous glands. Adolescence causes endocrine maturation of the adnexal elements, resulting in an accumulation of cellular products within the ductile systems. In addition to the cellular products are coexistent microorganisms, most commonly Propionibacterium acnes and Staphylococcus epidermidis.
  • Rosacea is a common condition characterized by symptoms of facial flushing and a spectrum of clinical signs, including erythema, telangiectasia, coarseness of skin, and an inflammatory papulopustule eruption resembling acne. Rosacea is defined by persistent erythema of the central portion of the face lasting for at least 3 months. Supporting criteria include flushing, papules, pustules, and telangiectasias on the convex surfaces. Secondary characteristics are burning and stinging, edema, plaques, a dry appearance, ocular manifestations, and phymatous changes.
  • Perioral dermatitis (POD) is a chronic papulopustular facial dermatitis. It mostly occurs in young women. The clinical and histologic features of the lesions resemble those of rosacea.
  • Warts are benign proliferations of skin and mucosa caused by the human papilloma virus (HPV).
  • HPV human papilloma virus
  • the primary clinical manifestations of HPV infection include common warts, genital warts, flat warts, and deep palmoplanar warts (myrmecia). Less common manifestations of HPV infection include focal epithelial hyperplasia (Heck disease), epidermodysplasia verruciformis, and plantar cysts.
  • Warts are transmitted by direct or indirect contact, and predisposing factors include disruption to the normal epithelial barrier. Treatment can be difficult, with frequent failures and recurrences.
  • Genital warts are a result of human papillomavirus (HPV) infection acquired by inoculation of the virus into the epidermis via defects in the epithelium (eg, maceration of the skin). Autoinoculation of virus into opposed lesions is common. Spread of HPV infection is usually through skin-associated virus and not from blood-borne infection.
  • HPV human papillomavirus
  • BP Bowenoid papulosis
  • Psoriasis is characterized by exceedingly rapid turnover of skin and appears as a chronic, bilaterally symmetric, erythematous plaquelike lesion with a silvery scale covering.
  • the lesions classically are located over the extensor surfaces, including the elbows, knees, back, and scalp. Confluent generalized lesions also may occur.
  • Necrobiosis lipoidica diabeticorum is a plaquelike, depressed, atrophic yellow lesion typically found in patients with diabetes. It has a strong association with diabetes and actually may be a clinical prodrome of the onset of the disease systemically. It rarely is found in locations other than the lower extremities and seldom is found in the absence of diabetes. The lesion tends to progress from a red plaquelike area to one with atrophy that occasionally may ulcerate.
  • Seborrheic dermatitis is a papulosquamous disorder patterned on the sebum-rich areas of the scalp, face, and trunk. In addition to sebum, this dermatitis is linked to Malassezia, immunologic abnormalities, and activation of complement.
  • Seborrheic keratosis (also known as seborrheic wart, senile wart, and basal cell papilloma) is a common benign tumor in advanced and middle-aged persons. It is typically a raised papular lesion of variable color from light to dark brown. Seborrheic keratosis may be smooth or wartlike with visible pitting. Common sites include the face, trunk, and extremities. The lesion also may be pedunculated or sessile. A variant known as dermatosis papulosa nigra occurs over the forehead and malar regions of individuals with black skin.
  • Acrochordons also known as skin tag, fibroepithelial polyp, fibroma molle, and fibroepithelial papilloma
  • They tend to be located in the intertriginous areas of the axilla, groin, and inframammary regions as well as in the low cervical area along the collar line. They are soft fleshy papules and usually, although not necessarily, pedunculated.
  • Actinic keratosis is the most common sun-related growth. Actinic keratoses are chiefly found on the sun-exposed areas of the face, the ears, the forearms, and the dorsum of the hands.
  • keratotic lesions may occur on any area that is chronically or repeatedly exposed to the sun, such as the back, the chest, and the legs. They usually appear as multiple discrete, flat or elevated, verrucous, keratotic lesions. Lesions typically have an erythematous base covered by scale (hyperkeratosis). They are usually 3-10 mm in diameter and gradually enlarge into broader, more elevated lesions. With time, actinic keratoses may develop into invasive cutaneous horns or skin cancers. Histologically, the epidermal changes are characterized by acanthosis, parakeratosis, and dyskeratoses. Cellular atypia is present, and the keratinocytes vary in size and shape. Mitotic figures are common.
  • Bowen disease also is known as carcinoma in situ and squamous intraepidermoid neoplasia. Lesions involve predominantly skin unexposed to the sun (ie, protected).
  • Bowen disease involves the genitalia. Itching is a common complaint. With vulvar involvement, the labia majora tend to be involved more than the labia minora. The lesions are scaly, crusted, erythematous plaques. Pseudocarcinomatous hyperplasia are lesions caused by a reparative process characterized by tongues of squamous epithelium growing downward into the dermis.
  • Nevus sebaceus of Jadassohn is a hamartomatous lesion expressing elements of sebaceous and apocrine glands, defective hair follicles, acanthosis, and papillomatosis. It is a congenital lesion, usually present on the scalp and face. The lesion tends to enlarge with time.
  • Lupus erythematosus is a heterogeneous connective-tissue disease associated with polyclonal B-cell activation.
  • Sebaceous adenoma is a nodular and lobulated lesion with peripheral generative cells and variable sebaceous differentiations as the center of the lesion is approached. It is not as organized as the patterns of sebaceous hyperplasia. This lesion is distinct from the hamartomatous variety encountered on the face of patients with tuberous sclerosis syndrome.
  • Inverted follicular keratosis is believed to be an inflammatory variant of Seborrheic keratosis. It commonly is found on the faces and sun-exposed areas of elderly patients.
  • this lesion is located on the upper eyelid. Anatomically, it represents an upside- down or endophytic process within the epithelium of a pilosebaceous follicle. The lesions tend to be single and present as a papule or nodule.
  • Trichoepithelioma is an uncommon benign lesion. It is generally pink to flesh colored. It is frequently multiple and is not ulcerative. These lesions tend to be recapitulations of hair follicles. Initially, they appear during adolescence. Typical areas for this lesion are the face and scalp and, less commonly, the trunk and neck.
  • Trichilemmoma is a benign tumor with a pattern of globular glycogen-rich clear cells. Occasionally, keratinization in the center is identified grossly. Molluscum sebaceum is a self-healing skin tumor. The lesion is classically a dome- shaped mound with a central crater of keratin.
  • Basal cell carcinoma is an epithelial malignancy that appears as insidious, painless, nonhealing ulcers or nodules on the sun-exposed parts of the body.
  • the most common location on the head is the nose, specifically the nasal tip and alae.
  • Risk is related to skin type and the degree of exposure to sunlight, particularly UV-B radiation.
  • the tumors are more frequent in individuals with fair complexions.
  • SCC Squamous cell carcinoma
  • SCC can arise from actinic keratosis, leukoplakia, radiation keratosis or dermatitis, scars, chronic ulcers, or chronic sinusitis.
  • People with actinic keratosis have atypical squamous cells in a third to a half of the epidermis.
  • Those with Bowen disease, or SCC in situ have atypical keratinocytes in the entire epidermis.
  • Invasive SCC involves the epidermis and invades the dermis.
  • the tumors initially appear as skin patches, plaques, and nodules that enlarge and develop central areas of inflammation, induration, and, subsequently, necrosis and oozing. SCCs metastasize by direct, lymphatic, and hematogenous extension.
  • Melanoma is a tumor that develops as a result of the malignant transformation of melanocytes. These cells are derived from the neural crest. Melanomas usually occur on the skin but can arise in other locations where neural crest cells migrate, such as in the gastrointestinal tract or brain.
  • compositions of the present invention find use in the treatment of all of the foregoing skin conditions and disorders.
  • compositions of the present invention also find use in the treatment of burns.
  • Sunburn is an acute cutaneous inflammatory reaction that follows excessive exposure of the skin to ultraviolet radiation (UVR). Exposure to solar radiation has the beneficial effects of stimulating the cutaneous synthesis of vitamin D and providing radiant warmth. Unfortunately, when the skin is subjected to excessive radiation in the ultraviolet range (wavelength ⁇ 400 ran), deleterious effects may occur. The most common is acute sunburn or solar erythema. Eyes, particularly the cornea (the clear window of tissue on the front of the eyeball), can be damaged easily by exposure to ultraviolet radiation from the sun and from other sources of ultraviolet light, such as a welder's arc, a photographer's flood lamps, a sun lamp, or even a halogen desk lamp.
  • UVR ultraviolet radiation
  • Second-degree burns involve damage to the top layer of skin (epidermis), and second-degree burns involve the epidermis and the underlying layer of skin (dermis).
  • First- and second-degree burns can also be called partial-thickness burns.
  • Third-degree burns affect the epidermis, dermis and hypodermis, causing charring of skin or a translucent white color, with coagulated vessels visible just below the skin surface. These are also called full-thickness burns.
  • Treating severely burned patients includes early cleaning and debriding of the wound, intravenous (IV) fluids containing electrolytes, systemic antibiotics, topical antibiotics, nutritional support and medication to control pain.
  • IV intravenous
  • Skin grafting generally with skin taken from donor sites from the patient, may be required to achieve closure of the wounded area.
  • autograft skin may not be available in sufficient quantities to completely close the wound.
  • expanded autografts are applied to the wound, and cadaver allograft is then used to close the wound completely.
  • Skin graft donor sites are surgically created wounds that require the same level of care as other open wounds.
  • compositions of the present invention also find use in the treatment of various types if internal wounds.
  • Wounds on internal tissues may be the result disease of surgery such as those created by of removal of cancerous tissues or correction of a cleft lip and/or palate. Wounds can form on the membranes of the mouth, nose and digestive system.
  • a cleft lip or palate affects the obvious facial form as an anatomic deformity and has functional consequences, affecting the child's ability to eat, speak, hear, and breathe.
  • the surgeon initially is faced with a protrusive premaxilla and the difficulty of achieving adequate columellar length and vertical height to the lip during reconstruction.
  • surgery for the bilateral cleft lip has undergone many recent advances, correction of the nasal deformities associated with this congenital malformation remains one of the greatest challenges in plastic surgery.
  • Surgical correction of nasal deformities associated with bilateral cleft lip is challenging because deformities may become apparent as the nose undergoes further growth and development.
  • Distraction osteogenesis is a technique in which bone can be lengthened by de novo bone formation as part of the normal healing process that occurs between surgically osteotomized bone segments that undergo gradual, controlled distraction.
  • Velopharyngeal (VP) dysfunction includes any structural and/or neuromuscular disorder of the velum and/or pharyngeal walls at the level of the nasopharynx in which interference with normal sphincteric closure occurs. VP dysfunction may result from anatomic, myoneural, behavioral, or a combination of disorders
  • Erythema multiforme is an acute mucocutaneous hypersensitivity reaction of variable severity characterized by a symmetrically distributed skin eruption, with or without mucous membrane lesions.
  • the more common mild form, EM minor consists of skin lesions with involvement of no more than one mucosal surface. Symmetrically distributed, erythematous, expanding macules or papules evolve into classic iris or target lesions, with bright red borders and central petechiae, vesicles, or purpura.
  • EM major, or Stevens- Johnson syndrome is more severe, involving 2 or more mucous membranes with more variable skin involvement. It may involve internal organs and typically is associated with systemic symptoms. Skin findings may be similar to EM minor but often are more variable and severe. Inflammatory vesiculobullous lesions, often with hemorrhage and necrosis, are typical.
  • Rhinitis is defined as inflammation of the nasal membranes and is characterized by a symptom complex that consists of any combination of the following: sneezing, nasal congestion, nasal itching, and rhinorrhea. The eyes, ears, sinuses, and throat can also be involved. Allergic rhinitis is the most common cause of rhinitis.
  • Crohn disease is an idiopathic, chronic, transmural inflammatory process of the bowel that can affect any part of the GI tract from the mouth to the anus. The condition is believed to be the result of an imbalance between proinflammatory and anti-inflammatory mediators. Most cases involve the small bowel, particularly the terminal ileum. The characteristic presentation of Crohn disease is with abdominal pain and diarrhea, which may be complicated by intestinal fistulization, obstruction, or both. The initial lesion starts as a focal inflammatory infiltrate around the crypts, followed by ulceration of superficial mucosa. Later, inflammatory cells invade deep layers and, in that process, begin to organize into noncaseating granulomas.
  • the granulomas extend through all layers of the intestinal wall and into the mesentery and the regional lymph nodes. Although granuloma formation is pathognomonic of Crohn disease, absence does not exclude the diagnosis.
  • the initial abnormality is hyperemia and edema of the involved mucosa. Later, discrete superficial ulcers form, which become deep serpiginous ulcers located transversely and longitudinally over an inflamed mucosa, giving the mucosa a cobblestone appearance.
  • the lesions are often segmental, being separated by healthy areas. Malabsorption occurs as result of loss of functional mucosal absorptive surface. This phenomenon can lead to protein-calorie malnutrition, dehydration, and multiple nutrient deficiencies.
  • Involvement of the terminal ileum may result in malabsorption of bile acids, which leads to steatorrhea, fat-soluble vitamin deficiency, and gallstone formation.
  • Fat malabsorption, by trapping calcium may result in increased oxalate excretion (normally complexed by calcium), causing kidney stone formation.
  • Gastritis includes a myriad of disorders that involve inflammatory changes in the gastric mucosa, including erosive gastritis caused by a noxious irritant, reflux gastritis from exposure to bile and pancreatic fluids, hemorrhagic gastritis, infectious gastritis, and gastric mucosal atrophy.
  • Peptic ulcer disease refers to a discrete mucosal defect in the portions of the gastrointestinal tract (gastric or duodenal) exposed to acid and pepsin secretion. Erosive gastritis usually is associated with serious illness or with various drugs. Stress, ethanol, bile, and nonsteroidal anti-inflammatory drugs (NSAIDs) disrupt the gastric mucosal barrier, making it vulnerable to normal gastric secretions. Infection with Helicobacter pylori, a short, spiral-shaped, microaerophilic gram-negative bacillus, is the leading cause of PUD and is associated with virtually all ulcers not induced by NSAIDs. Oral herpes is an infection caused by the herpes simplex virus. The virus causes painful sores on your lips, gums, tongue, roof of your mouth, and inside your cheeks. It also can cause symptoms such as fever and muscle aches.
  • compositions of the present invention further find use in enhancing the various phases of the healing process.
  • the inflammatory phase begins with the injury itself.
  • the inflammatory phase is characterized by hemostasis and inflammation. Here you have bleeding, immediate narrowing of the blood vessels, clot formation, and release of various chemical substances into the wound that will begin the healing process.
  • Specialized cells clear the wound of debris over the course of several days. Collagen exposed during wound formation activates the clotting cascade (both the intrinsic and extrinsic pathways), initiating the inflammatory phase.
  • the cell membranes damaged from the wound formation, release thromboxane A2 and prostaglandin 2-alpha, potent vasoconstrictors. This initial response helps to limit hemorrhage. After a short period, capillary vasodilatation occurs, secondary to local histamine release, and the cells of inflammation are able to migrate to the wound bed.
  • Platelets the first response cell, release multiple chemokines, including epidermal growth factor (EGF), fibronectin, fibrinogen, histamine, platelet-derived growth factor (PDGF), serotonin, and von Willebrand's factor. These factors help stabilize the wound through clot formation. These mediators act to control bleeding and limit the extent of injury. Platelet degranulation also activates the complement cascade, specifically C5a, which is a potent chemoattractant for neutrophils. The inflammatory phase continues, and more immune response cells migrate to the wound.
  • chemokines including epidermal growth factor (EGF), fibronectin, fibrinogen, histamine, platelet-derived growth factor (PDGF), serotonin, and von Willebrand's factor. These mediators act to control bleeding and limit the extent of injury. Platelet degranulation also activates the complement cascade, specifically C5a, which is a potent chemoattractant for neutrophils. The inflammatory phase continues, and more immune response cells migrate to the
  • the second response cell to migrate to the wound is responsible for debris scavenging, complement-mediated opsonization of bacteria, and bacteria destruction via oxidative burst mechanisms (ie, superoxide and hydrogen peroxide formation).
  • the neutrophils kill bacteria and decontaminate the wound from foreign debris.
  • the next cells present in the wound are the leukocytes and the macrophages (monocytes).
  • the macrophage referred to as the orchestrator, is essential for wound healing. Numerous enzymes and cytokines are secreted by the macrophage.
  • collagenases which debride the wound
  • interleukins and tumor necrosis factor (TNF) which stimulate fibroblasts (produce collagen) and promote angiogenesis
  • TGF tumor necrosis factor
  • TGF tumor necrosis factor
  • This step marks the transition into the process of tissue reconstruction, ie, the proliferative phase.
  • TNF tumor necrosis factor
  • TGF tumor necrosis factor
  • This step marks the transition into the process of tissue reconstruction, ie, the proliferative phase.
  • TGF tumor necrosis factor
  • This step marks the transition into the process of tissue reconstruction, ie, the proliferative phase.
  • TGF tumor necrosis factor
  • This step marks the transition into the process of tissue reconstruction, ie, the proliferative phase.
  • TGF tumor necrosis factor
  • This step marks the transition into the process of tissue reconstruction, ie, the proliferative phase.
  • a matrix or latticework of cells forms.
  • new skin cells and blood vessels will form
  • Epithelialization, angiogenesis, granulation tissue formation, and collagen deposition are involved in the proliferation phase anabolic portion of wound healing.
  • Epithelialization occurs early in wound repair. If the basement membrane remains intact, the epithelial cells migrate upwards in the normal pattern. This is equivalent to a first-degree skin burn. The epithelial progenitor cells remain intact below the wound, and the normal layers of epidermis are restored in 2-3 days. If the basement membrane has been destroyed, similar to a second- or third-degree burn, then the wound is reepithelialized from the normal cells in the periphery and from the skin appendages, if intact (eg, hair follicles, sweat glands)
  • Angiogenesis stimulated by TNF-alpha, is marked by endothelial cell migration and capillary formation.
  • the new capillaries deliver nutrients to the wound and help maintain the granulation tissue bed.
  • the migration of capillaries into the wound bed is critical for proper wound healing.
  • the granulation phase and tissue deposition require nutrients supplied by the capillaries, and failure for this to occur results in a chronically unhealed wound.
  • Mechanisms for modifying angiogenesis are under study and have significant potential to improve the healing process.
  • fibroblasts differentiate and produce ground substance and then collagen. The ground substance is deposited into the wound bed; collagen is then deposited as the wound undergoes the final phase of repair.
  • Many different cytokines are involved in the proliferative phase of wound repair. The steps and the exact mechanism of control are not well understood. Some of the cytokines include PDGF, insulinlike growth factor (IGF), and EGF.
  • the framework (collagen) becomes more organized making the tissue stronger.
  • the blood vessel density becomes less, and the wound begins to lose its pinkish color.
  • the area increases in strength, eventually reaching 70% of the strength of uninjured skin.
  • the wound undergoes contraction, ultimately resulting in a smaller amount of apparent scar tissue.
  • the entire process is a dynamic continuum with an overlap of each phase and continued remodeling.
  • the wound reaches maximal strength at one year, with a tensile strength that is 30% of normal skin. Collagen deposition continues for a prolonged period, but the net increase in collagen deposition plateaus after 21 days.
  • Epithelialization is the process of laying down new skin, or epithelial, cells.
  • the skin forms a protective barrier between the outer environment and the body. Its primary purpose is to protect against excessive water loss and bacteria. Reconstruction of this layer begins within a few hours of the injury and is complete within 24-48 hours in a clean, sutured (stitched) wound. Open wounds may take 7-10 days because the inflammatory process is prolonged, which contributes to scarring. Scarring occurs when the injury extends beyond the deep layer of the skin (into the dermis).
  • the 3 categories of wound closure are primary, secondary, and tertiary.
  • Primary healing involves closure of a wound within hours of its creation.
  • Secondary healing involves no formal wound closure; the wound closes spontaneously by contraction and reepithelialization.
  • Tertiary wound closure also known as delayed primary closure, and involves initial debridement of the wound for an extended period and then formal closure with suturing or by another mechanism.
  • compositions of the present invention further find use for the treatment of scars, alone or in combination with known scar treatments.
  • Open wounds can result in a number of complications including wound infection and disfiguring scars including keloids, widened scars, and hypertrophied scars.
  • Both keloid and hypertrophic scars are wounds that heal overzealously above the skin surface.
  • the difference between a keloid and a hypertrophied scar is that a keloid continues to enlarge beyond the original size and shape of the wound, while a hypertrophied scar enlarges within the confines of the original wound.
  • both can be red and raised, keloids continue to grow and hypertrophied scars tend to regress over time.
  • Keloid formation has a genetic basis, as demonstrated by its predilection for persons of certain races and in certain families. Because keloids tend to demonstrate accelerated growth during puberty or pregnancy and tend to resolve with menopause, hormones (both androgen and estrogen) have been implicated in keloid formation. Other hormones linked to keloid formation include thyroid hormone alterations and melanocyte- stimulating hormones. Immunologic alterations are implicated in abnormal scars. Specifically, irregular immunoglobulin and complement levels, increased transforming growth factor-beta, and mast cells are found in abnormal scars.
  • Collagen production is elevated in keloid biopsy samples and in cultured fibroblasts derived from keloids. Increased collagen production by cultured fibroblasts derived from keloids persists throughout their in vitro life span; they do not revert to normal after transfer of the lesion to culture. No significant differences in DNA content or cellularity are found when keloid dermis is compared with normal dermis. This suggests that each fibroblast is producing more collagen rather than an increase occurring in the number of fibroblasts producing a normal amount of collagen. In keloid formation, excessive collagen production by fibroblasts is likely due to the wound environment. Widened scar formation is thought to result from wound edge separation with tension perpendicular to the healing skin wound. A state of tension exists naturally in skin; wounded skin gapes and becomes elliptical rather than round. When a wound is closed opposite to the lines of tension, the chance of widened scar formation is increased.
  • Hypertrophic scars are self-limited; they hypertrophy within the confines of the wound. Initially, hypertrophied scars can be raised, red, pruritic, and even painful; however, over time, they become pale and flat. Hypertrophied scars appear worst at 2 weeks to 2 months. Keloid scars can be differentiated from hypertrophic scars by their spread beyond the original wound. Keloid scars tend to remain red, pruritic, and painful for many months to years until menopause. Patients usually have a personal or familial history of keloid formation. Different from hypertrophic and keloid scars, widened scars are flat and sometimes depressed. With adequate wound maturation, these wounds fade to the pigment of the surrounding uninjured skin. Widened scars are not usually red or pruritic.
  • the relaxed skin tension lines follow furrows formed when the skin is relaxed. Unlike wrinkles, they are not visible features of the skin. They are merely derived from the furrows produced by pinching on the skin. These furrows are produced preferably with pinching perpendicular to the lines. When the skin is pinched oblique to the relaxed skin tension lines, an S-shaped pattern is created. Fewer and higher furrows are created if skin is pinched parallel to the lines. Closing incisions opposite to the relaxed skin tension lines can increase the risk of widened or hypertrophic scar formation.
  • a potential relative contraindication to scar revision surgery exists when the scar is a keloid because of the risk of worsening the scar.
  • Widened scars can be easily differentiated from hypertrophic and keloid scars based on findings from a physical examination. Widened scars are flat and sometimes even depressed. Hypertrophic scars and keloids are indistinguishable under light microscopy.
  • Keloids contain thick collagen fibers with increased epidermal hyaluronic content, whereas hypertrophic scars exhibit nodular structures with fine collagen fibers and increased levels of alpha smooth muscle actin.
  • collagen in both keloids and hypertrophic scars is organized in discrete nodules, frequently obliterating the rete pegs in the papillary dermis of the lesions. While collagen in normal dermis is arranged in discrete fascicles separated by considerable interstitial space, collagen nodules in keloids and in hypertrophic scars appear avascular and unidirectional and are aligned in a highly stressed configuration.
  • ACE wraps elastic bandages
  • thromboembolic disease stockings thromboembolic disease stockings
  • Isotoner-type gloves on extremities.
  • custom-fitted compression garments can be used to apply pressure to the more difficult areas, including the neck and torso. Because these devices are uncomfortable, patient compliance varies. Unfortunately, for optimal results, these devices must be used for 6-12 months during the maturation of the wound.
  • Silicone gel can be used to treat abnormal scars. Silicone gel is shown to significantly decrease scar volume when used over time particularly for hypertrophic scar formation. The effect of the silicone gel on the scar is believed to be due to wound hydration.
  • the silicone gel is applied to the wound for at least 12 h/d. Patients find it more appealing to apply the silicone to their wounds at night. Silicone gel is gaining popularity because it can be applied to a smaller area for 12 h/d, usually at night. However, skin breakdown, rashes, and difficulty with wound adherence can lead to disuse.
  • Triamcinolone injections have become a common nonsurgical option in the treatment of problem scars.
  • the steroid used for intralesional injection is triamcinolone (Kenalog).
  • Triamcinolone injections have been the standard treatment to induce flattening, fading, and decreased symptomatology of hypertrophied scars. These injections can be administered as soon as a problem scar is identified.
  • the dose of the injection can vary from 10-120 mg, depending on the size of the scar.
  • Adverse effects of triamcinolone injections include hypopigmentation and subcutaneous atrophy.
  • Other nonsurgical options include corticosteroid intralesional injections, vitamin E therapy, zinc oxide therapy, antineoplastic agents, and immunotherapy.
  • Closing wounds to orient the wound along the relaxed skin tension lines is important.
  • a standard practice often used rather subconsciously after excision of a lesion involves assessing the direction of least tension based on the configuration of the edges of the wound or by pinching the wound.
  • the first-line procedure used for scar revision is fusiform excision.
  • fusiform excision does not require lengthening the scar.
  • the Millard flap procedure is similar to fusiform excision, but it involves preserving the scar and its connection to the underlying fat.
  • the skin is incised in a fusiform fashion around the scar to the subcutaneous level.
  • the scar is then deepithelialized, and the skin edges are approximated over the deepithelialized scar.
  • the Millard flap technique is preferred for widened, depressed scars.
  • Scars not oriented along the relaxed skin tension lines can be modified with a Z- plasty procedure. Limbs of equal length are created for the Z plasty. The angle of the Z dictates the length of scar tension distribution and elongation (eg, 30° for 25%, 45° for 50%, 60° for 75%, 75° for 100%, 90° for 120%).
  • the W-plasty technique for scar revision is similar to Z plasty because of the result of breaking up a straight-line scar into a pattern that is less conspicuous. Similar to a fusiform excision, W plasty involves the removal of skin; therefore, avoid this method if significant tension is present across the wound edges.
  • W- plasty scar revision is preferred for scars along relaxed skin tension lines; scars with a bowstring contracture; short, depressed scars; and facial scars.
  • Tissue expansion and serial excision can be considered for larger scar revisions when excess wound tension is predicted. If more than 2 serial excisions are expected, tissue expansion is preferred.
  • other procedures that have been described to treat scars include dermabrasion, cryosurgery, and laser therapy. Widened scars may be treated differently than hypertrophied scars. Widened scars can be flat or even depressed.
  • Widened scars are preferably treated with the Millard 2-flap technique over a deepithelialized scar. This technique provides soft tissue fill under the approximated wound edges. Furthermore, if the widened scar recurs, the risk for another recurrence may be minimized by reorienting the wound tension along the lines of relaxed skin tension. Other adjuncts described in the treatment of widened scars include the injection of fat grafts or other tissue substitutes. When oriented close to the relaxed skin tension lines, hypertrophic scars can be excised in a fusiform fashion. If the hypertrophic scar developed because of excessive tension across the wound as a result of unfavorable wound orientation, Z plasty can sometimes help reorient the wound to distribute tension in a different direction to minimize the risk of recurrence.
  • compression garments and silicone gel are preferred for 4-6 months to decrease the risk of recurrence. Patients are encouraged to refrain from strenuous activities for at least 6 weeks, until which time the wound achieves approximately 80% original wound tensile strength. Patients are monitored for 6 months postoperatively to detect and potentially circumvent recurrences early. Postoperatively, patients are at risk for hypertrophic scar and widened scar recurrence. Other risks include infection, hematoma, seroma, and painful or unattractive scarring. The risk of recurrence is significant for both hypertrophic and widened scars, and it is increased with repeat operations. Wound healing requires approximately 1 year, during which time the surgeon and patient should observe for and expect improvement. Once the scar has had an opportunity to mature, scar revision can be considered.
  • compositions comprising cell extracts are utilized to improve any area of the person visible and contributing to cosmetic appearance of a person, including but not limited to skin, hair, nails, teeth, subcutaneous fat, cartilage, muscle and skeletal structures.
  • the described gene-gun and microinjection delivery methods are contemplated to introduce extracts or extract components to structures below the surface skin of a person.
  • This invention relates to prevention of deterioration, damage and malfunction of cells and tissues, and to promote, improve and exceed cellular function in order to promote, improve and exceed appearance, vitality and health by treating cells and tissues with differentiable cells, cell or egg extracts, or components of said extracts including signaling molecules, peptides, carbohydrates, lipids or nucleic acids.
  • the current invention contemplates the assessment of a persons needs for healing, regeneration or repair of damage by several means, including but not limited to analysis and measurements of visible surfaces, skin pH, thickness, structure and elasticity of skin layers, analysis of blood or tissue samples by microchip, RT-PCR, Mass spectrometry, high pressure liquid chromatography, ELISA-assays, RNA analysis, analysis of accumulation of DNA damage or defective genes by DNA sequencing, assessment of internal organ and tissue health by X-ray imaging, ultrasound imaging, computed tomogpraphy (CT), magnetic resonance imaging (MRI), positron emission tomography (PET).
  • CT computed tomogpraphy
  • MRI magnetic resonance imaging
  • PET positron emission tomography
  • Subcutaneous fat contributes to the cosmetic appearance of a person, and is redistributed during ageing, by smoking and in a number of diseases, including HIV and diabetes as well as in burn-victims.
  • the human immunodeficiency virus (HIV)- lipodystrophy syndrome is associated with fat redistribution and metabolic abnormalities, including insulin resistance.
  • Increased intramyocellular lipid (IMCL) concentrations are thought to contribute to insulin resistance, being linked to metabolic and body composition variables.
  • IMCL intramyocellular lipid
  • calf subcutaneous fat area and extremity fat are reduced.
  • Extremity fat is significantly associated with IMCL among HIV-infected patients, controlling for visceral abdominal fat, abdominal subcutaneous fat, and antiretroviral medications in a regression model.
  • current treatment include (1) weight loss with differing responses seen with regards to insulin resistance depending on the size of the fat depot; (2) peroxisome proliferator activated receptor gamma agonists, such as thiazoledinediones which expand the subcutaneous fat depot, (3) expanding alternate storage sites for triglycerides by a variety of techniques, such as resistance training-induced muscle hypertrophy, may also improve insulin resistance; (4) drugs, such as beta 3 adrenergic receptor agonists which promote lipolysis may increase insulin resistance by releasing free fatty acids into the circulation.
  • Inhibitors of the beta oxidation of free fatty acids may cause insulin resistance by sparing fat and (5) liposuction, by reducing the size of the subcutaneous fat depot may worsen insulin resistance, thus increasing the risk of type 2 diabetes mellitus (Cherian MA, Santoro TJ, Med Hypotheses. 2005 Dec 14; [Epub ahead of print]).
  • ovarian and other steroids are important to the metabolism of skin and hair, the changes in body composition and the alterations of the subcutaneous fat distribution throughout life. So called aesthetic endocrinology accesses deficiency or excess of ovarian steroids that lead to different problems skin and hair and other non-genital, i.e., obesity and cellulite.
  • Sex steroids are small molecules that are transported into the skin by topical application when properly formulated, and are contemplated to be added to the extracts presented in this invention in order to achieve local effects but to avoid systemic reactions.
  • Estrogens, delivered orally or topically may counteract the aging of the skin especially post-menopause. Estrogen alone is not sufficient for reconstitution of juvenile skin but may slow the skin aging process.
  • compositions contemplated by this invention may serve to be a different way of treating hair loss.
  • the compositions contemplated may stimulate hair sack follicles to regrow or increase the rate and quality of hair, as well as nails.
  • Estrogens also contribute to hirsutism (the excessive growth of thick dark hair in locations where hair growth in women usually is minimal or absent), acne and changes in body composition. (Gruber CJ, et al., Current concepts in aesthetic endocrinology. Gynecol Endocrinol. 2002 Dec; 16(6) :431 -41).
  • compositions in the present invention are additionally contemplated for use in hair loss and baldness in males which may be caused by hormones, diet, cancer, chronic illness or stress. It is contemplated that the present invention can be used to regulate hair growth by stimulating or modulating hair follicle cells to either reduce or enhance or regenerate hair growth in desired areas by topical or sub-dermal applications. This invention is also useful in the treatment of cellulite.
  • Cellulite is a common term used to describe superficial pockets of trapped fat, which cause uneven dimpling or "orange peel" skin. It appears in 90% of post-adolescent women and is rarely seen in men. Common but not exclusive areas where cellulite is found, are the thighs, buttocks, and the abdomen.
  • cellulite is not related to obesity, since it occurs in overweight, normal, and thin women.
  • Cellulite can be aided by mechanized devices with motorized rollers and regulated suction.
  • This non-surgical and non-invasive device creates a symmetrical skin fold, which allows for deep tissue mobilization to occur and results in reduction of cellulite and loss of inches.
  • the present invention contemplates application of extracts topically or subcutaneously to regulate the distribution of subcutaneous fat deposits and improve the cosmetic appearance of areas affected by cellulite.
  • the present invention may be useful for the repair or rejuvenation or de novo formation of damaged tissues, organs and cells beneath the skin, including all internal organs and tissues, including but not limited to muscle, fat, cartilage, bone, connective tissue, spleen, liver, pancreas, lungs and nervous tissue. Damages to the internal tissues or organs may be induced by i.e. accidents, diseases, medication, cancer, radiation and surgery.
  • MOF multi-organ failure
  • TGF- ⁇ transforming growth factor- ⁇
  • compositions comprising intact stem cells (embryonic or adult) or cord-blood stem cells are utilized for cosmetic or therapeutic purposes.
  • suspensions of cells in fluid form are introduced to the skin.
  • suspensions of cells in fluid form are introduced into an open wound, and then covered by a wound dressing which can breathe (non occlusive).
  • a wound dressing which can breathe (non occlusive).
  • an occlusive wound dressing is utilized.
  • one or more layers are utilized, for example a waterproof plastic membrane which can be glued onto skin, a layer of a nutrient gel which can nourish cells and speed wound healing (containing antibacterial agents, collagen modulating substances and other substances); and a layer of skin stem cells embedded in/placed on the nutrient layer, which are put in direct contact with the wound.
  • the cells are cultured in the lab from the person's own skin, adipose, or stem cells.
  • the cells are then harvested and put in suspension, either to be applied as a fluid or placed on a plastic membrane with nutrient gel-layer to be applied to skin as an occlusive wound dressing/plaster/band-aid.
  • the extracts are utilized for ex vivo treatment of cells derived from a patient. Briefly, cells are recovered from a patient, expanded, permeabilized, incubated with the extract, sealed, and then used for treatment of a patient. In this process, a number of the cells properties could be altered or enhanced, including but not limited to lengthening of telomeres — the terminal chromosomes protecting the central DNA contained in the chromosome which are shortened with each cell division - thus renewing and lengthening the life-span of the cell treated. Preferred methods are described in Example 3.
  • the extracts are utilized in vivo on the patient's internal organs and/or tissues or cells.
  • the extract or components thereof could be injected to the intraperitoneal cavity, thus bathing the surface of abdominal organs including but not limited to the intestines, liver, spleen, pancreas, stomach and bladder thus inducing healing of wounds in these organs and tissues or aiding in regeneration of the cells which the organs and/or tissues are composed of.
  • tissue including but not limited to muscle, brain, fat, connective tissue, cartilage, pancreas, liver, spleen, heart and lungs as to induce de novo cell formation in tissues and organs and/or rejuvenate the cells from which the tissues/organs are composed.
  • De novo cell formation occurs spontaneously in organisms including humans.
  • De novo formation of local lymphoid tissue by dendritic dells which are the most potent professional antigen-presenting cells (Ludewig B et al.,1998 J Exp Med).
  • telomeres Life is manifested in growth.
  • growth can be of two types, heterotrophic and autotrophic.
  • Autotrophic growth uses inorganic material for nourishment. Heterotrophic growth is dependent on organic material for nourishment. During germination, seedlings usually grow heterotropically but once a plant becomes photosynthetic it can grow autotrophically - using minerals from the soil and atmosphere and sunlight for energy. Thus, for most of their life plants are autotrophic. However, there are some parasitic plants that grow heterotropically, obtaining inorganic material from their host.
  • growth is serial, repetitive and plastic, and cell divisions contribute to de novo formation of organs all the way through to senescence. In animals, cell division serves to regenerate and maintain tissues and circulating cell populations, and growth is concurrently repetitive and dependent on the length of the telomeres which are shortened at each cell division.
  • This invention contemplates using both organic materials and inorganic materials contained in or added to extracts to nourish, stimulate and regulate cell growth, function and de novo formation in all organs and tissues.
  • Plant seeds contain materials for heterotropic growth and are contemplated for use in extracts to aid cell growth in humans.
  • Regeneration of amputated limbs in amphibians is one of the best-studied model systems and a useful paradigm for understanding many features of vertebrate organ regeneration.
  • this system includes cellular dedifferentiation in the injured tissues of the limb stump and proliferation of these cells to form a distal blastema that undergoes patterning and growth to restore the missing limb structures.
  • the question of why limbs of phylogenetically advanced vertebrates fail to regenerate has been addressed by studies with limbs of anuran amphibians. Regeneration is excellent in the earliest stages of limb development in anurans (frogs and toads) but gradually diminishes as larvae approach metamorphosis (Dent, 1962). Limbs of adult anurans are incapable of complete regeneration.
  • urodele amphibians newts and salamanders
  • urodele amphibians commonly regenerate limbs and often other organs such as tails, jaws, and parts of the eye throughout their lifetimes.
  • Such regenerative phenomena are very rare among reptiles, birds, and mammals as adults, suggesting that the loss of regenerative capacity may have been an adaptive part of the evolutionary transition toward the more advanced tetrapods.
  • cells of differentiating muscle and other tissues in the anuran limb lose their ability to revert to the proliferative state and contribute to limb regrowth.
  • Regeneration requires epithelial-mesenchymal interactions at the distal limb stump like those that drive embryonic limb development, and the changing nature of wound closure after amputation of anuran limbs during the transition from larvae to adults has also been studied. Closure of limb stumps in mammals involves contraction of full-thickness skin and in adult frogs involves rapid formation of connective tissue beneath the apical wound epidermis that initially covers the cut surface (Carlson, 1974). Tassava and Olsen (1982) suggested that the inability of higher vertebrates to form a functional wound epithelium explains the lost potential for regeneration.
  • adaptive immunity which supplements more general and primitive innate immune mechanisms and allows an organism to acquire highly specific defense mechanisms against invading microorganisms, may have yielded immune cells and cytokines whose activity in traumatized tissue is inimical to cell dedifferentiation or the signaling required to initiate limb regeneration, so that the response to injury in the presence of such immunity is dominated by tissue repair and fibrosis rather than regeneration (Mescher and Neff, 2005).
  • the present invention contemplates to increase the plasticity and alter the growth potential of cells and tissues by increasing cellular dedifferentiation and tissue dissociation, thereby allowing de novo generation of cells, tissues and organs. Alterations of immune- responses by active substances in the extracts are also contemplated.
  • NCCIT Jurkat (clone E6-1) and 293T cells (American Type Culture Collection, Bethesda, MD) are cultured in RPMI 1640 (Sigma, St. Louis, MO) with 10% fetal calf serum (FCS), 2 mM L-glutamine, 1 mM sodium pyruvate and non-essential amino acids (complete RPMI).
  • FCS fetal calf serum
  • NIH3T3 Swiss-Albino fibroblasts (American Type Culture Collection) are cultured in Dulbecco's modified Eagle's medium (DMEM; Sigma) with 10% FCS, L- glutamine and 0.1 mM ⁇ -mercaptoethanol.
  • Mouse ESCs are isolated from inner cell masses of strain svl29 blastocysts and plated on mouse fibroblast ⁇ -irradiated feeder layers in ESC medium (DMEM, 15% FCS, 0.1 mM ⁇ -mercaptoethanol, non-essential amino acids, 1% penicillin/streptomycin) supplemented with 1,000 units/ml (10 ng/ml) of recombinant leukemia inhibitory factor (LIF; Sigma) on gelatin-coated plates. Prior to harvesting for preparing extracts, ESCs are passaged and cultured under feeder-free conditions in RPMI containing 10 ng/ml LIF.
  • RPMI recombinant leukemia inhibitory factor
  • NCCIT extracts To prepare NCCIT extracts, cells are washed in phosphate buffered saline (PBS) and in cell lysis buffer (100 mM HEPES, pH 8.2, 50 mM NaCl, 5 mM MgCb, 1 mM dithiothreitol and protease inhibitors), sedimented at 400 g, resuspended in 1 volume of cold cell lysis buffer and incubated for 30-45 min on ice. Cells are sonicated on ice in 200- ⁇ l aliquots using a Labsonic-M pulse sonicator fitted with a 3-mm diameter probe (B. Braun Biotech, Melsoder, Germany) until all cells and nuclei are lysed, as judged by microscopy.
  • PBS phosphate buffered saline
  • cell lysis buffer 100 mM HEPES, pH 8.2, 50 mM NaCl, 5 mM MgCb, 1 mM dithiothrei
  • lysate is sedimented at 15,000 g for 15 min at 4°C to pellet the coarse material. The supernatant is aliquoted, frozen in liquid nitrogen and stored. Lysate of 95,583 ⁇ 10,966 NCCIT cells is used to generate extract.
  • ESC extracts 25-30 mg/ml protein
  • 293T, Jurkat and NIH3T3 extracts are also prepared as above. If necessary, extracts are diluted with H2O prior to use to adjust osmolality to ⁇ 300 mOsm.
  • the upper lip containing the vibrissa pad of a subject is cut and its inner surface was exposed.
  • hairs from the scalp or other haired body parts may be used instead of vibrissa.
  • the vibrissa or hair follicles are dissected under a binocular microscope.
  • the vibrissa are plucked from the pad by pulling them gently by the neck with fine forceps.
  • the isolated vibrissae were washed in DMEM-Fl 2 (GIBCO/BRL), containing B-27 (GIBCO/BRL) and 1% penicillin/streptomycin (GIBCO/BRL). All surgical procedures were done under a sterile environment.
  • the vibrissa follicular bulge area contained nestin expressing cells.
  • the cells were isolated by exposure to fluorescent anti-nestin antibodies under fluorescence microscopy.
  • the isolated cells were suspended in 1 ml of DMEM-F12 containing B-27 with 1% methylcellulose (Sigma- Aldrich), and 20 ng ml "1 basic FGF (bFGF) (Chemicon).
  • bFGF basic FGF
  • HBSS Hank's balanced salt solution
  • Sedimented cells are suspended in 97.7 ml cold HBSS, tubes placed in a H2O bath at 37°C for 2 min and 2.3 ml SLO (Sigma; 100 mg/ml stock diluted 1 : 10 in cold HBSS) is added to a final SLO concentration of 230 ng/ml. Samples are incubated horizontally in a H 2 O bath for 50 min at 37°C with occasional agitation and set on ice. Samples are diluted with 200 ml cold HBSS and cells are sedimented at 120 g for 5 min at 4 0 C.
  • Permeabilization is assessed by monitoring uptake of a 70,000 Mr Texas red-conjugated dextran (Molecular Probes, Eugene, OR; 50 ⁇ g/ml) in a separate sample 24 h after resealing and replating the cells. Permeabilization efficiency under these conditions is ⁇ 80%. Following permeabilization, cells to be reprogrammed ex vivo are suspended at
  • the tube containing cells is incubated horizontally for 1 h at 37°C in a H 2 O bath with occasional agitation.
  • the extract is diluted with complete RPMI containing 2 mM CaCl 2 and antibiotics, and cells are seeded at 100,000 cells per well of a 48-well plate. After 2 h, floating cells are removed and plated cells are cultured in complete RPMI. The reprogrammed cells can be transplanted back into patient.
  • a cream base made from any combination of lipids and/or proteins and/or water containing cell extracts.
  • Example 5 Preparation of fish egg extracts
  • Fresh, unfertilized salmon (Salmo salar) eggs harvested from females in reproductive phase (late fall) are kept on ice, and the extract preferably made immediately. It is possible to freeze dry eggs in a cryoprotectant (e.g., 1.5 M 1,2-propanediol and 0.2 M sucrose) without disrupting the egg membrane. Freezing should be gradual (-l°C/min) to — 80 0 C. Eggs should be thawed and kept on ice throughout the extract preparation procedure. Eggs are washed twice in HBSS or seawater with protease inhibitors (lOug/ml).
  • the washing solution is removed and the eggs are lysed and homogenized in a pre-chilled Dounce glass-glass homogenizator.
  • the lysate is transferred to Beckman Ultra Clear polyallomer centrifuge tubes (5 ml) while avoiding transfer of egg shells, and centrifugated for 15 min at 15.000g at 4 0 C in a Beckman ultracentrifuge using SW55T1 rotor. Three fractions are thereby obtained; lipid top fraction, cytoplasmic middle fraction, and a bottom fraction containing eggshells and nucleic debris.
  • the cytoplasmic middle fraction is the collected extract.
  • This extract is expected to contain most cytosolic organelles including mitochondria, lysosomes and peroxisomes, should be clear and viscous, and have an orange tint.
  • Protease inhibitors (10ug/ml stock) are added and extracts are kept at -8O 0 C. Further fractionation of the cytoplasmic extract is possible. Centrifugation at -8O 0 C.
  • the extract is prepared from eggs/roe by crushing (cell cracker or dounce-homogenization) or centrifugation at different speeds to separate cytoplasm with all content, with/without eggshells (zona pellucida), with/without nucleus/cytosol, with/without organelles, with/without lipids. Further fractionation can be conducted to isolate one or more of mRNA, proteins, small peptides, carbohydrates and lipids.
  • Major components of fatty acids in the roe are oleic acid, linoleic acid, and omega-3 fatty acids.
  • the salmon egg extracts Upon application of the above protocol for salmon egg extracts, the salmon egg extracts had a surprizingly high protein concentration varying from 100 — 380 mg/ml, pH between 6.4 — 6.8, and an osmolarity of approximately 350 mOsm.
  • the extracts were clear and viscous and non-filterable (by 0.45 um MiIIiQ filter).
  • the protein in the extract precipitated easily upon addition of water or hydrous solutions with low buffering capacity due to the high protein content and low pH. Extracts could be neutralized to pH 7.0 by addition of alkaline (1-3 ul IM NaOH/ml extract), whereupon dilution in water and hydrous solutions was possible.
  • Zebra-fish extracts had a protein concentration varying from 23 - 26 mg/ml, pH between 6.4 - 6.8, and an osmolarity between 80 - 150 mOsm.
  • the extracts were clear and non-viscous, filterable and diluted readily in water at all dilutions.
  • Extracts with low pH and that contain certain substances may be toxic to cells. Toxicity of each batch should be tested on each cell type that is to be reprogrammed. Cells are harvested and washed twice in HBSS. Approximately 100,000 cells are pelleted and resuspended in 100 ul extract and incubated in a waterbath at 37 0 C for 1 hour. Dilutions of the extracts may be tested to assess cell survival in extracts of varying protein concentration, pH and osmolality. Optimally, protein concentration should be more than 25 mg/ml, pH should be close to 7.2, and osmolarity close to 280 mOsm.
  • Cells and extract are incubated in wells with normal media (as suited to cell type chosen) for 24 hours, and the morphology of the cells inspected by microscopy. Cells are harvested, stained, and viable cells counted. If more than 50% of cells are non-viable after culture, the extract is considered toxic.
  • 293T cells were viable for at least 3 weeks after incubation with extracts of salmon eggs and zebra fish embryo with protein concentrations varying from 24 — 380 mg/ml, at osmolalities between 140 — 350 and pH 6.9 - 7.7. At osmolarity below 140 mOsm, the cells died.
  • RNA isolated from extracts may be isolated from extracts by the method of choice, for example by using a Qiagen RNeasy Plus Kit (Qiagen). The RNA is quantified by spectrophotometer, and stored at -8O 0 C. lug RNA is used for cDNA synthesis. cDNA synthesis may be conducted for example, by using the iScript cDNA Synthesis Kit (Bio-Rad), followed by PCR conducted with primers of choice. Positive controls are included for each primer set tested.
  • PCR products are run on a 1 % agarose gel with ethidium bromide and bands visualized by UV lamp.
  • PCR products of extracts obtained by specific primers for human genes of interest as seen on agarose gels were compared to bands obtained from positive control human cell lines previously shown to express genes herein investigated (e.g., OCT4, NANOG, SOX2, UFTl , GAPDH, REXl (a.k.a. ZFP42), LMN-A, LMN-Bl, OXT2, ACI33, APL and STELLA).
  • the cell type of choice e.g., human 293T cells and adipose stem cells (ASC tested)
  • ASC tested adipose stem cells
  • Approximately 100,000 to 500,000 cells are pelleted by centrifugation (300g, 4°C for 10 minutes).
  • Cells may be permeabilized with streptolysin-O (SLO) by incubation for 50 minutes in a 37°C waterbath prior to reprogramming, however this is not necessary for reprogramming effects offish egg or embryo extracts. After SLO incubation, cells are washed in ice cold HBSS, centrifugated and excess liquid removed from pellet.
  • SLO streptolysin-O
  • Cells are resuspended in 100 ul extract per 100,000 cells and incubated for 1 hour at 37°C in a waterbath. Approximately 100,000 cells are seeded in wells with complete media of choice. If SLO permeablization has been conducted, cells are cultured in media with 2mM CaCl 2 for 2 hours after reprogramming to reseal the cell membranes. The media should be changed 2-12 hours after reprogramming.
  • Cells are cultured in wells until proliferation allows splitting to larger vessels. Split cells as appropriate for the cell type, but do not allow them to become confluent. Pellets for gene-analysis should be collected weekly and morphology assessed by phase-contrast microscopy at each passage. Cells can be cultured as long as desired, but to assess lasting reprogramming effects, 40 days is a suggested minimum.
  • cells may be reprogrammed by incubation in media inhance with fish egg or embryo extracts.
  • Cells are reprogrammed by adding 0.4% extract to normal complete medium (10% FCS) or starvation media (0.5% FCS) .
  • Cells of choice are grown to 50 % confluency, and normal medium replaced with complete medium or starvation medium containing 0.4 % extract.
  • Split cells as appropriate with media containing extract.
  • Fresh medium with extracts should be added to cells at least two times per week if splitting less than twice weekly.
  • Pellets for gene-analysis should be collected weekly and morphology assessed by phase-contrast microscopy at each passage. Cells can be cultured as long as desired, but to assess lasting reprogramming effects, 40 days is a suggested minimum.
  • Results show an up-regulation (18 to 100 times) of the OCT-4 gene in all cells treated with extracts compared to untreated cells.
  • the changes in NANOG gene expression are more modest, with an up-regulation varying from none to 5 times.
  • the up-regulation seen varied from 2 to 8 times over basal.
  • Reprogrammed cells with morphological changes and gene expression changes as shown below were additionally labeled with OCT4 and NANOG antibodies and visualized with fluorescent secondary antibodies in a confocal microscope to verify increased expression of these genes.
  • the studies presented herein give proper protocols for preparing fish egg extracts, characterization and toxicity tests of such extracts, protocols for cell reprogramming with the extracts, as well as results of changes induced by the extracts upon cells.
  • the results include morphological changes presented as microscopic images, as well as changes in gene expression in the treated cells presented as real-time PCR data.
  • Reprogramming of 293T cells has been conducted 17 individual times, with changes in morphology observed in 12 of the 17 reprogrammings. Alterations in gene expression has been observed in 8 of 12 studied (gene expression analysis for the reprogrammings is still under work). Alterations in morphology are correlated with changes in gene expression, i.e.
  • Morphology of cells reprogrammed with salmon egg extracts or extracts of zebra- fish embryos change after approx. 3 days. 293T cells become rounder, and some populations of cells start to grow in blastoma like spheres. These changes are persistent, and can be observed until 21 days (experiment terminated), although in certain conditions the changes seem to reverse towards normal 293T morphology after 2 weeks.
  • normal 293T cells with extract added to normal media RPMI- 1640 with 10%FCS and 0,2% extract
  • similar changes in morphology can be observed as seen for reprogrammed cells cultured in normal media.
  • cells cultured with salmon egg extracts in particular have an increased growth rate compared to normal cells.
  • mice were divided in 3 cages, each with 2 controls and 2 treated animals.
  • the wound healing process was monitored over 12 days, with measures taken including wound areas, days until complete healing (reepithelialization and loss of scab), and size of resulting scar.
  • Biopsies were taken on day 1 and day 12 for further analysis, and wounds were photographed regularly to document healing progress.
  • mice A/J or NMRI albino males.
  • Ethanol for sterilization of skin prior to wound induction Small surgical scissors and micro scissors, surgical blades and tweezers. Salmon egg-extract, batch LE4, prepared as described above.
  • Isofluran gas FORENE Isofluran Vnr 506949, lot 22397 VA, exp 2009-10 (Abbott, Solna,
  • Vaporizer Datex-Ohmeda Isotec 5 Liquid nitrogen for biopsy samples. 4% PFA (in PBS) for biopsy samples.
  • mice Healthy inbred male NMRl or A/J mice (separate studies), weighing between 25 g and 35 g were obtained from the animal house of the Institute of National Public Health, Oslo, Norway. The mice were acclimatized for one week prior to the experiments, and housed in polypropylene cages on normal food and water ad libitum, and were ear-labeled (1-4 in each cage) one week prior to start of the experiments. Animals were periodically weighed before and after experiments. The mice were anaesthetized prior to infliction of the experimental wounds. The surgical interventions were carried out under sterile conditions using isofluran gas (oxygen + isofluran mixed in vaporizer). Animals were closely observed for any infection; those which showed signs of infection were separated and excluded from the study. An acute toxicity study was conducted for the extracts as described elsewhere in this patent. The study was approved by the Ethics Committee of Norway.
  • mice Excision and incision wounds. Each mouse was inflicted with one excision wound (Morton JJP, Malone MH. Evaluation of vulnerary activity by an open wound procedure in rats. Arch Int Pharmacodyn. 1972; 196:117-126) and one incision wound (Ehrlich HP, Hunt TK. Effect of cortisone and vitamin A on wound healing. Ann Surg. 1968; 167:324-328.).
  • the mice were anaesthetized prior to creation of the wounds, with isofluran gas (by mask, system details below).
  • the dorsal fur of the animal was shaved with electric clipper and the area of the excision wound to be created was outlined on the left side of the back of the animals with waterproof, permanent marker.
  • the control group wounds were left untreated.
  • the parameters studied were wound closure, wound size, scar size, epithelialisation time, and histology (morphological parameters of the skin).
  • the measurements of the wound areas of the excision wound model were taken on 1st, 5 th, 9th and 12th day following the initial wound using transparent paper and a permanent marker.
  • the wounds on each mouse were photographed daily with a digital camera (see details below).
  • the period of epithelialisation was calculated as the number of days required for the wounds to become scab free. Biopsies.
  • the skin excised in the creation of the excision wound was kept as a normal skin biopsy, allowing each animal to be its own control in later biopsy analysis.
  • One half of the biopsy was fixed in 4% PFA, the other snap- frozen in liquid nitrogen.
  • granulation tissue formed on the wound was excised on the 12th postoperative day, after the termination of the animals by cervical dislocation or CO2 gas. Excision and incision wounds were surgically removed along the initial wound induction markings.
  • One half of the biopsy was fixed in 4% PFA, the other half snap-frozen in liquid nitrogen for later analysis.
  • Sections were stained with H&E and parameters of the scar, including the thickness of the granulation tissue, were measured in the microscope.
  • HEMATOXYLIN SOLUTION ACC TO MAYER
  • eosin (1 min) Sigma HTl 101 16 EOSIN Y SOLUTION ALCOHOLIC
  • rinsed shortly in water and dehydrated from 70% through 96% to absolute ethanol followed by 2x5 min in xylol.
  • Sections were mounted directly from xylol with Eukitt (Sigma 03989-
  • Measurements were taken as follows: Epidermal thickness was measured from the stratum germinatum (basal keratinocytes) to the stratum comeum. Dermal thickness was measured from below the stratum germinatum to the subcutis (adipose tissue below dermis). Total skin thickness was measured as combined thickness of epidermis and dermis.
  • the scar diameter at day 12 was measured between the wound healing tongues on either side of the scar tissue, and compared to the day 1 excision wound diameter (1 cm). Distance between hair sacks was measured between the centres of the hair papillae of adjacent hairs (proximal to the scar at day 12).
  • the measurements show that there is less variance in scar thickness, diameter, epidermal and dermal thickness in treated animals compared to the untreated controls.
  • the extract treated animals displayed a more normal epidermal thickness (closer to epidermal thickness as measured in the same animals at day 1), and the distance between the newly formed hair sacs proximal to the scar were more evenly distributed (more similar to hair sack distribution in normal skin at day 1 ), while the hair sacs of the healed skin in control animals was more disorganized and distributed with a smaller distance between hair sacs compared to normal skin.
  • the data show that extract treated animals have 41% thinner scar (total skin thickness at centre of scar) compared to untreated controls, and the newly formed epithelium in the healed skin is 148% thinner, and the new dermis 7% thinner in treated animals compared to untreated controls. Additionally, the diameter between new hair sacs is 16% closer to pre-operative distance in treated animals compared to untreated controls.
  • OCT3/4 is a marker of embryonic and other stem cells, found predominately in the nucleus.
  • OCT4 (green) staining was detected in the basal layer of epidermis (proliferating keratinocytes) (novel finding).
  • Interfollicular keratinocytes in culture have previously been transfected with OCT-4 which resulted in increased expression of Sox-2, Nanog, Uftl and Rex-1.
  • NANOG expression often follows the expression of OCT4 in stem cells. NANOG labeling was detected at the base of hair sacks (hair stem cells) as well as in migrating cells along the wound healing tongue at day 12 (novel found)
  • CALRETlN IN is a calcium-binding protein shown to be present in the companion cell layer of the human hair follicle. Calretinin staining was seen along the hair shafts as expected. CALBINDIN is found in the nucleus and cytoplasm of epidermal keratinocytes
  • Example 12 Reprogr a mming of human skin fibroblasts and HEK cells.
  • hsF cells human skin Fibroblasts
  • hsF cells used were from ACCT.
  • Reprogramming hsF on coverslips including SLO Objective: To reprogram cells with a nuclear-free extract to alter gene expression, morphology and elements of growth and to study changes in state of differentiation.
  • hsF cells grown in 24-well plate on coverslips (ca 100.000 cells sown out per well in starvation media ca 5 days earlier and ca 50.000 cells sown out per well in normal media ca 3 days earlier); Extract (salmon egg extract); Incubation in media for control; 1 xPBS; Ca 2 + free Hanks Balanced Salt Solution (HBSS) at 4°C; TE to loosen hsF cells from flask; SLO stock of 100 ⁇ g/ml diluted 1:100 in HBSS; ATP (200 mM stock in water); GTP (10 mM stock in water); Phosphocreatine (2M stock in water); Creatine kinase (5mg/ml stock in water); Autoclaved MQ water; Waterbath at 37°C; CaCl 2 (2mM) enriched medium: 10OmM CaC12 stock is prepared by mixing l,67g CaC12 with 15ml distilled water and sterile filtered.
  • HBSS free Hanks Balanced
  • 2mM concentration of CaC12 is made by e.g. mixing 50 ⁇ l of 10OmM CaC12 with 2450 ⁇ l of reprogramming medium. Procedure: Wash cells twice in ice cold IxPBS (1 ml). Wash cells twice in cold HBSS (1 ml).
  • Table 8 Fold upregulation of the developmentally regulated OCT4 and NANOG genes, relative to GAPDH, as assessed by qPCR.
  • DAPI (1 :1000) was added to second to last rinse.
  • Coverslips were mounted with ProLong Gold Antifade reagent (Molecular Probes) and images were taken with a fluorescence microscope (Olympus) or confocal microscope (Zeiss).
  • OCT4 staining was seen in the cytoplasm of most cells, stronger labeling was seen in the reprogrammed cells compared to the normal control, which showed very weak staining.
  • Hoechst staining was observed in the nuclei of normal cells, additionally overlapping with OCT4 staining in the cytoplasm of the reprogrammed cells. The cells were assessed for infection to ensure the cytoplasmic Hoechst stain was not caused by mycoplasma but rather a true expression of reprogramming.
  • HEKa cells Human Epidermal Keratinocytes — adult Keratinocyte Culture Systems from Cascade Biologies EXTENDED-LIFESPAN SYSTEMS Basal Medium EpiLife® Medium Growth Supplement HKGS (S-001 -5)
  • Reprogramming of HEKa cells (without SLO) Objective: To reprogram cells with a nuclear-free extract to alter gene expression, morphology and elements of growth and to study changes in state of differentiation.
  • HEKa cells used for the experiment were grown in their normal media (EpiLife with HGKS and alternatively 1% GA [after reprogramming]). "Mock" reprogramming was conducted as control (cells undergo reprogramming procedure in normal media without extract added) and normal HEKa cells were cultured in parallel as negative control.
  • 293T were reprogrammed in the same experiment, also including one mock reprogramming and 1 flask of normal 293T as controls. 293T are grown in their normal media (RPMI with 1%PS).
  • HBSS Hanks Balanced Salt Solution
  • TN Tropomycin Neutralizing solution
  • ATP 200 mM stock in water
  • GTP 10 mM stock in water
  • Creatine kinase 5mg/ml stock in water
  • NTP 25 mM stock
  • Autoclaved mq water 75 cm2 flasks; 15 ml, 1.5 ml tubes Centrifuge cooled to 4°C; Swing out bucket rotor for 1.5 ml tubes, and for 15 ml tubes ; Waterbath at 37°C. Procedure:
  • Immunofluorescence Cells were fixed on coverslips on day 9 after reprogramming. Immunofluorescence labeling was conducted as described for hSF cells.
  • HEK cells were immunolabeled for OCT4 (same procedure and antibody as for hSF cells) and nuclei identified by Hoechst stain in a fluorescent microscope. Normal HEK cells showed very weak OCT4 staining in the nuclei, while nuclei of a subpopulation of HEK cells reprogrammed with salmon egg extract were clearly more strongly stained with OCT4, in agreement with qPCR results showing an upregulation of OCT4 in cells from the same reprogramming. Hoechst staining was overlapping with OCT4 staining in the nuclei of most cells, and OCT4 staining was especially strong in the nucleoli of the reprogrammed cells.
  • Negative controls showed no OCT4 staining while nuclei were normally stained by Hoechst. Identical settings for microscope and digital image capture were used when observing cells.

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